| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,213 |
1,806 |
$121K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,159 |
1,676 |
$74K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,465 |
1,089 |
$62K |
| 96160 |
|
2,693 |
1,043 |
$51K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
273 |
231 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
625 |
470 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
419 |
355 |
$27K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,705 |
2,095 |
$22K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
575 |
488 |
$20K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
894 |
385 |
$11K |
| 90677 |
|
199 |
159 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
878 |
754 |
$11K |
| 96161 |
|
523 |
320 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
96 |
80 |
$7K |
| 87631 |
|
42 |
41 |
$7K |
| 99215 |
Prolong outpt/office vis |
109 |
66 |
$7K |
| 36416 |
|
2,719 |
2,046 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
79 |
70 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
140 |
122 |
$4K |
| 92551 |
|
433 |
376 |
$3K |
| 99173 |
|
386 |
349 |
$2K |
| 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) |
188 |
140 |
$2K |
| 96127 |
|
338 |
312 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
14 |
$999.46 |
| 99381 |
|
15 |
12 |
$805.86 |
| 90461 |
|
919 |
672 |
$665.25 |
| 99174 |
|
57 |
53 |
$608.52 |
| 90658 |
|
63 |
42 |
$534.26 |
| 90670 |
|
233 |
187 |
$432.58 |
| 90688 |
|
92 |
86 |
$410.62 |
| 90698 |
|
224 |
187 |
$398.33 |
| 90680 |
|
150 |
124 |
$321.33 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
12 |
$264.77 |
| A4258 |
Spring-powered device for lancet, each |
2,656 |
1,984 |
$134.08 |
| 90744 |
|
133 |
105 |
$93.30 |
| 90633 |
|
41 |
38 |
$35.04 |
| D0190 |
|
33 |
12 |
$24.00 |
| 99000 |
|
648 |
509 |
$2.04 |
| A4651 |
Calibrated microcapillary tube, each |
2,648 |
1,984 |
$0.00 |