| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,467 |
18,756 |
$1.98M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,720 |
25,166 |
$1.75M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
10,319 |
8,857 |
$1.35M |
| 99199 |
Unlisted special service, procedure or report |
233,223 |
152,629 |
$1.29M |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
3,617 |
2,833 |
$827K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,173 |
5,544 |
$571K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,078 |
4,459 |
$508K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16,521 |
14,987 |
$331K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,240 |
8,455 |
$311K |
| 99401 |
|
6,934 |
5,470 |
$245K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
8,397 |
7,121 |
$235K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,551 |
2,373 |
$235K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,569 |
1,487 |
$136K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
1,696 |
1,430 |
$105K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,551 |
2,327 |
$94K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,792 |
3,825 |
$92K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,673 |
7,799 |
$84K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,981 |
4,852 |
$67K |
| 99051 |
|
2,312 |
2,163 |
$57K |
| 90837 |
Psychotherapy, 53 minutes with patient |
571 |
269 |
$52K |
| 92552 |
|
15,810 |
14,153 |
$37K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
1,609 |
1,354 |
$36K |
| 96127 |
|
6,876 |
6,040 |
$34K |
| 85018 |
|
19,416 |
17,172 |
$32K |
| 90651 |
|
1,103 |
936 |
$32K |
| 81002 |
|
11,739 |
10,342 |
$25K |
| 99215 |
Prolong outpt/office vis |
181 |
153 |
$22K |
| 69210 |
|
528 |
406 |
$16K |
| 90734 |
|
510 |
431 |
$8K |
| 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) |
285 |
280 |
$8K |
| 81025 |
|
890 |
745 |
$6K |
| 90686 |
|
3,979 |
3,559 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
333 |
278 |
$6K |
| D0145 |
Oral evaluation for a patient under three years of age |
116 |
115 |
$4K |
| 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) |
123 |
120 |
$4K |
| 90633 |
|
1,313 |
1,278 |
$3K |
| 90620 |
|
39 |
39 |
$3K |
| 90474 |
|
135 |
132 |
$3K |
| 0072A |
|
43 |
39 |
$3K |
| 0071A |
|
33 |
33 |
$2K |
| D1206 |
Topical application of fluoride varnish |
116 |
115 |
$2K |
| 0001A |
|
20 |
17 |
$1K |
| 99173 |
|
9,734 |
9,081 |
$1K |
| 99177 |
|
4,512 |
3,754 |
$875.09 |
| 87807 |
|
41 |
41 |
$579.33 |
| 36415 |
Collection of venous blood by venipuncture |
200 |
173 |
$508.50 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
45 |
42 |
$478.46 |
| 90688 |
|
130 |
130 |
$437.60 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
29 |
14 |
$414.91 |
| 36410 |
|
26 |
25 |
$345.69 |
| 90656 |
|
186 |
183 |
$259.82 |
| 90619 |
|
150 |
130 |
$152.41 |
| 90716 |
|
91 |
91 |
$124.91 |
| 90715 |
|
43 |
40 |
$43.25 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
27 |
26 |
$1.06 |
| 90671 |
|
53 |
51 |
$0.08 |
| 90677 |
|
14 |
12 |
$0.06 |
| 90670 |
|
1,079 |
1,045 |
$0.01 |
| 91300 |
|
41 |
36 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90707 |
|
92 |
91 |
$0.00 |
| 90698 |
|
320 |
306 |
$0.00 |
| 91307 |
|
156 |
138 |
$0.00 |
| 99174 |
|
263 |
238 |
$0.00 |
| 90680 |
|
186 |
183 |
$0.00 |
| 99000 |
|
242 |
234 |
$0.00 |
| 91305 |
|
27 |
24 |
$0.00 |
| 94760 |
|
15 |
13 |
$0.00 |
| 90744 |
|
37 |
37 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |