| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39,709 |
34,998 |
$2.44M |
| 99199 |
Unlisted special service, procedure or report |
298,454 |
150,158 |
$1.83M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,576 |
6,405 |
$588K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,994 |
5,757 |
$538K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,395 |
5,059 |
$460K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,329 |
3,994 |
$386K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18,881 |
17,709 |
$363K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
10,374 |
9,718 |
$362K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,508 |
3,273 |
$334K |
| 99401 |
|
7,533 |
6,942 |
$239K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,511 |
1,376 |
$195K |
| D0145 |
Oral evaluation for a patient under three years of age |
5,182 |
5,039 |
$181K |
| 99408 |
|
4,388 |
4,046 |
$129K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
11,875 |
11,447 |
$115K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,258 |
2,118 |
$82K |
| D1206 |
Topical application of fluoride varnish |
5,148 |
5,008 |
$79K |
| 99051 |
|
2,248 |
2,083 |
$55K |
| 96127 |
|
11,467 |
10,760 |
$53K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,790 |
3,592 |
$51K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,606 |
1,724 |
$49K |
| 90474 |
|
2,303 |
2,123 |
$44K |
| 99173 |
|
15,771 |
14,920 |
$26K |
| 99381 |
|
202 |
182 |
$21K |
| 92551 |
|
7,048 |
6,766 |
$16K |
| 90651 |
|
427 |
381 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
246 |
243 |
$10K |
| 90734 |
|
408 |
354 |
$9K |
| 90686 |
|
5,244 |
4,968 |
$7K |
| 87807 |
|
461 |
423 |
$6K |
| 0071A |
|
149 |
73 |
$5K |
| 96161 |
|
1,346 |
1,204 |
$5K |
| 0072A |
|
90 |
65 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
166 |
156 |
$3K |
| G0315 |
Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt) |
110 |
108 |
$3K |
| G0312 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes) |
88 |
87 |
$3K |
| 90633 |
|
1,835 |
1,741 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
100 |
94 |
$2K |
| 90715 |
|
59 |
37 |
$424.33 |
| 90716 |
|
901 |
840 |
$363.74 |
| 90688 |
|
23 |
17 |
$270.91 |
| 90707 |
|
894 |
833 |
$86.79 |
| 81003 |
|
14 |
13 |
$37.83 |
| 99072 |
|
2,657 |
2,493 |
$2.30 |
| 99000 |
|
2,977 |
2,787 |
$1.13 |
| 90670 |
|
3,517 |
3,264 |
$0.00 |
| 90671 |
|
773 |
749 |
$0.00 |
| 90700 |
|
61 |
57 |
$0.00 |
| 90685 |
|
31 |
31 |
$0.00 |
| 90647 |
|
2,648 |
2,451 |
$0.00 |
| 90723 |
|
2,621 |
2,424 |
$0.00 |
| 90656 |
|
409 |
390 |
$0.00 |
| 90680 |
|
2,369 |
2,186 |
$0.00 |
| 90696 |
|
111 |
96 |
$0.00 |
| 91307 |
|
239 |
138 |
$0.00 |