| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,751 |
9,046 |
$394K |
| S8301 |
Infection control supplies, not otherwise specified |
10,802 |
8,178 |
$223K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,925 |
2,477 |
$126K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,475 |
1,449 |
$110K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
8,757 |
7,510 |
$107K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
745 |
691 |
$102K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,601 |
2,337 |
$96K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,081 |
1,979 |
$94K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,252 |
1,153 |
$88K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,881 |
3,588 |
$81K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
970 |
956 |
$76K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,758 |
1,568 |
$72K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,359 |
2,865 |
$67K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
446 |
437 |
$36K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,706 |
1,286 |
$34K |
| 99429 |
|
886 |
867 |
$28K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,188 |
3,786 |
$25K |
| 92567 |
|
2,847 |
2,487 |
$25K |
| 87428 |
|
381 |
364 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,028 |
689 |
$8K |
| 90461 |
|
1,082 |
923 |
$6K |
| 99050 |
|
319 |
305 |
$5K |
| 81002 |
|
1,281 |
1,172 |
$3K |
| 0071A |
|
85 |
84 |
$3K |
| 0072A |
|
77 |
76 |
$3K |
| 86580 |
|
336 |
334 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
154 |
146 |
$2K |
| 0002A |
|
44 |
44 |
$2K |
| 0001A |
|
35 |
35 |
$1K |
| 0082A |
|
30 |
30 |
$1K |
| 87807 |
|
113 |
108 |
$1K |
| 0081A |
|
36 |
36 |
$1K |
| 0154A |
|
34 |
33 |
$960.00 |
| 99381 |
|
13 |
13 |
$932.88 |
| 0073A |
|
24 |
24 |
$920.00 |
| 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) |
19 |
18 |
$701.46 |
| 0124A |
|
13 |
13 |
$520.00 |
| 0003A |
|
12 |
12 |
$440.00 |
| 99051 |
|
52 |
50 |
$268.92 |
| 90686 |
|
1,846 |
1,816 |
$97.23 |
| 96160 |
|
30 |
30 |
$47.25 |
| 99000 |
|
12 |
12 |
$43.20 |
| 90671 |
|
238 |
238 |
$0.43 |
| 90620 |
|
13 |
13 |
$0.01 |
| 90651 |
|
32 |
32 |
$0.01 |
| 90716 |
|
171 |
169 |
$0.00 |
| 90698 |
|
104 |
101 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 90670 |
|
662 |
644 |
$0.00 |
| 90648 |
|
272 |
267 |
$0.00 |
| 90700 |
|
159 |
159 |
$0.00 |
| 90707 |
|
148 |
147 |
$0.00 |
| 90681 |
|
177 |
171 |
$0.00 |
| 90633 |
|
183 |
181 |
$0.00 |
| 91300 |
|
64 |
50 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |