| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
317 |
284 |
$127K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,804 |
3,422 |
$122K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,271 |
2,039 |
$111K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
701 |
687 |
$67K |
| 0001A |
|
1,006 |
999 |
$38K |
| 0002A |
|
951 |
944 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
342 |
324 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
326 |
287 |
$28K |
| 99177 |
|
1,261 |
1,220 |
$18K |
| 99188 |
|
861 |
844 |
$15K |
| 0071A |
|
332 |
331 |
$13K |
| 0072A |
|
289 |
288 |
$12K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
888 |
826 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
588 |
279 |
$7K |
| G0008 |
Administration of influenza virus vaccine |
634 |
603 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
113 |
112 |
$6K |
| 0004A |
|
131 |
115 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
46 |
45 |
$4K |
| 92587 |
|
123 |
119 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
39 |
$3K |
| 0124A |
|
87 |
75 |
$3K |
| 99382 |
|
30 |
29 |
$3K |
| 87631 |
|
15 |
15 |
$2K |
| 96127 |
|
286 |
281 |
$2K |
| 90686 |
|
1,003 |
964 |
$2K |
| 0054A |
|
47 |
44 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
63 |
$2K |
| 0064A |
|
39 |
39 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
190 |
149 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
226 |
213 |
$1K |
| 99383 |
|
12 |
12 |
$1K |
| 99173 |
|
183 |
181 |
$1K |
| 92551 |
|
139 |
135 |
$1K |
| 92552 |
|
117 |
116 |
$932.00 |
| 0074A |
|
21 |
21 |
$800.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
54 |
44 |
$670.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
69 |
65 |
$660.00 |
| 0134A |
|
18 |
15 |
$600.00 |
| 0012A |
|
22 |
22 |
$564.25 |
| 0154A |
|
12 |
12 |
$480.00 |
| 0011A |
|
24 |
24 |
$372.68 |
| G0136 |
Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months |
58 |
58 |
$367.21 |
| 90651 |
|
101 |
99 |
$283.92 |
| 99401 |
|
27 |
26 |
$260.00 |
| 87807 |
|
21 |
19 |
$258.51 |
| 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) |
24 |
24 |
$230.00 |
| 85018 |
|
70 |
70 |
$226.10 |
| 90620 |
|
13 |
13 |
$214.96 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
21 |
21 |
$161.28 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
19 |
19 |
$145.92 |
| 90619 |
|
128 |
125 |
$140.00 |
| 83655 |
|
12 |
12 |
$110.00 |
| 96160 |
|
26 |
26 |
$90.48 |
| 90633 |
|
25 |
25 |
$80.00 |
| 90734 |
|
61 |
59 |
$60.00 |
| 96161 |
|
16 |
12 |
$55.68 |
| 90670 |
|
26 |
26 |
$50.00 |
| 90715 |
|
109 |
101 |
$20.00 |
| 91305 |
|
12 |
12 |
$1.00 |
| 91320 |
|
35 |
33 |
$0.00 |
| 91300 |
|
138 |
130 |
$0.00 |
| 90656 |
|
76 |
76 |
$0.00 |
| 91319 |
|
13 |
13 |
$0.00 |
| 91307 |
|
63 |
62 |
$0.00 |