| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,671 |
8,966 |
$598K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,210 |
3,953 |
$382K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,802 |
4,760 |
$167K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,433 |
1,378 |
$143K |
| 99070 |
|
2,709 |
2,458 |
$129K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,386 |
1,352 |
$128K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
4,143 |
3,412 |
$110K |
| D1206 |
Topical application of fluoride varnish |
2,147 |
2,131 |
$109K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
927 |
915 |
$83K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,627 |
1,562 |
$47K |
| 99401 |
|
1,652 |
1,561 |
$41K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
853 |
800 |
$40K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
397 |
384 |
$32K |
| 87999 |
|
2,365 |
2,101 |
$32K |
| 99188 |
|
2,342 |
2,238 |
$27K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,030 |
2,924 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,413 |
1,345 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
615 |
600 |
$22K |
| 92587 |
|
1,482 |
1,436 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
895 |
883 |
$19K |
| 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) |
809 |
799 |
$18K |
| 90461 |
|
449 |
435 |
$14K |
| 92015 |
Determination of refractive state |
827 |
822 |
$14K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
351 |
332 |
$11K |
| 99177 |
|
833 |
780 |
$11K |
| 96127 |
|
2,336 |
2,252 |
$11K |
| 92567 |
|
779 |
735 |
$8K |
| 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) |
355 |
352 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
326 |
285 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
408 |
397 |
$4K |
| 36416 |
|
804 |
698 |
$2K |
| 94760 |
|
1,648 |
1,528 |
$2K |
| 0072A |
|
38 |
38 |
$2K |
| 99383 |
|
13 |
13 |
$1K |
| 90688 |
|
733 |
722 |
$1K |
| 0071A |
|
38 |
28 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
57 |
$820.83 |
| 85018 |
|
422 |
411 |
$615.30 |
| 90480 |
|
13 |
13 |
$541.97 |
| 83655 |
|
61 |
59 |
$440.07 |
| 87301 |
|
58 |
56 |
$374.32 |
| 90473 |
|
12 |
12 |
$266.64 |
| 99058 |
|
13 |
13 |
$255.97 |
| D0145 |
Oral evaluation for a patient under three years of age |
108 |
107 |
$225.50 |
| 96161 |
|
116 |
104 |
$183.96 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
55 |
54 |
$132.65 |
| 81002 |
|
52 |
47 |
$100.87 |
| 99174 |
|
25 |
25 |
$87.88 |
| D0120 |
Periodic oral evaluation - established patient |
76 |
70 |
$33.24 |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
52 |
47 |
$0.39 |
| 90671 |
|
47 |
45 |
$0.21 |
| 90651 |
|
137 |
135 |
$0.19 |
| 90620 |
|
14 |
14 |
$0.04 |
| 99072 |
|
2,826 |
2,485 |
$0.00 |
| 99173 |
|
710 |
698 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
991 |
970 |
$0.00 |
| 90670 |
|
94 |
94 |
$0.00 |
| 90633 |
|
39 |
38 |
$0.00 |
| 90713 |
|
37 |
37 |
$0.00 |
| 90700 |
|
61 |
61 |
$0.00 |
| 90734 |
|
43 |
38 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
198 |
192 |
$0.00 |
| 99051 |
|
58 |
57 |
$0.00 |
| S0516 |
Safety eyeglass frames |
70 |
65 |
$0.00 |
| 90672 |
|
94 |
82 |
$0.00 |
| A4928 |
Surgical mask, per 20 |
71 |
66 |
$0.00 |
| 90621 |
|
18 |
13 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 91300 |
|
12 |
12 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
1,780 |
1,747 |
$0.00 |
| 99000 |
|
3,098 |
2,905 |
$0.00 |
| 90686 |
|
2,064 |
1,957 |
$0.00 |
| 90656 |
|
162 |
162 |
$0.00 |
| 3011F |
|
57 |
55 |
$0.00 |
| 91307 |
|
79 |
64 |
$0.00 |
| 97802 |
|
484 |
472 |
$0.00 |
| 90647 |
|
15 |
15 |
$0.00 |
| 99441 |
|
17 |
16 |
$0.00 |
| 90698 |
|
13 |
12 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |