| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64,106 |
55,198 |
$2.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37,838 |
32,227 |
$1.55M |
| 99233 |
Prolong inpt eval add15 m |
41,248 |
16,739 |
$1.52M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14,423 |
13,208 |
$1.06M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
11,301 |
10,809 |
$882K |
| 99223 |
Prolong inpt eval add15 m |
9,480 |
8,994 |
$702K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
56,443 |
23,633 |
$621K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
3,079 |
2,905 |
$140K |
| 74240 |
|
1,637 |
1,224 |
$135K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,697 |
1,543 |
$130K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15,835 |
14,040 |
$126K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,857 |
1,788 |
$89K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,135 |
1,023 |
$89K |
| 99220 |
|
1,417 |
1,342 |
$88K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
126 |
121 |
$71K |
| 90461 |
|
16,111 |
14,110 |
$67K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
792 |
770 |
$63K |
| 99460 |
|
864 |
835 |
$53K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,052 |
1,005 |
$48K |
| 59514 |
|
78 |
74 |
$47K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,371 |
1,299 |
$47K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,842 |
1,836 |
$46K |
| 76830 |
Ultrasound, transvaginal |
501 |
472 |
$42K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,442 |
615 |
$37K |
| 99217 |
|
1,024 |
981 |
$30K |
| 81003 |
|
17,863 |
11,885 |
$29K |
| 76818 |
|
379 |
196 |
$29K |
| 99381 |
|
427 |
416 |
$28K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
10,253 |
9,073 |
$22K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,792 |
1,653 |
$22K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
352 |
227 |
$22K |
| 54150 |
|
440 |
419 |
$18K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
435 |
403 |
$18K |
| 59025 |
Fetal non-stress test |
532 |
297 |
$17K |
| 76801 |
|
201 |
185 |
$15K |
| 99226 |
|
389 |
306 |
$13K |
| 99215 |
Prolong outpt/office vis |
236 |
208 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
128 |
124 |
$11K |
| 59430 |
|
112 |
111 |
$10K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
109 |
100 |
$10K |
| 87428 |
|
382 |
363 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
232 |
228 |
$10K |
| 99222 |
Initial hospital care, per day, moderate complexity |
260 |
241 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
136 |
126 |
$8K |
| 81025 |
|
1,398 |
1,335 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
120 |
120 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
588 |
581 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
237 |
228 |
$5K |
| 99205 |
Prolong outpt/office vis |
60 |
58 |
$5K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
54 |
52 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
97 |
95 |
$4K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
113 |
110 |
$3K |
| 87430 |
|
227 |
226 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
264 |
209 |
$3K |
| 93000 |
|
790 |
716 |
$3K |
| 99225 |
|
124 |
95 |
$2K |
| 99253 |
|
42 |
41 |
$2K |
| 90686 |
|
4,457 |
4,241 |
$2K |
| 87807 |
|
176 |
155 |
$2K |
| 92587 |
|
145 |
128 |
$1K |
| 43235 |
|
16 |
16 |
$1K |
| 90677 |
|
1,566 |
1,488 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
120 |
112 |
$845.60 |
| 99254 |
|
13 |
12 |
$827.62 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
22 |
13 |
$782.15 |
| 51798 |
|
312 |
285 |
$758.43 |
| 87400 |
|
56 |
28 |
$618.35 |
| 87420 |
|
50 |
50 |
$583.34 |
| 92551 |
|
84 |
75 |
$547.92 |
| 99000 |
|
53 |
50 |
$453.04 |
| 99219 |
|
13 |
12 |
$432.65 |
| 92552 |
|
29 |
29 |
$432.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
31 |
24 |
$364.62 |
| 90715 |
|
12 |
12 |
$362.21 |
| 96160 |
|
86 |
85 |
$162.87 |
| 78492 |
|
15 |
15 |
$89.92 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
40 |
40 |
$85.65 |
| 99462 |
|
13 |
12 |
$76.08 |
| 90656 |
|
577 |
574 |
$36.68 |
| 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) |
512 |
476 |
$32.76 |
| 90670 |
|
6,519 |
6,381 |
$27.50 |
| 90697 |
|
1,484 |
1,377 |
$0.01 |
| 0503F |
|
63 |
58 |
$0.00 |
| 3008F |
|
21,492 |
17,386 |
$0.00 |
| 3074F |
|
12,779 |
10,631 |
$0.00 |
| 3044F |
|
1,323 |
1,057 |
$0.00 |
| 90698 |
|
2,757 |
2,691 |
$0.00 |
| 90723 |
|
503 |
496 |
$0.00 |
| 3079F |
|
2,082 |
1,784 |
$0.00 |
| 90680 |
|
4,811 |
4,643 |
$0.00 |
| 1125F |
|
683 |
610 |
$0.00 |
| 90744 |
|
627 |
611 |
$0.00 |
| 3075F |
|
165 |
142 |
$0.00 |
| 99024 |
|
397 |
259 |
$0.00 |
| 3061F |
|
1,011 |
818 |
$0.00 |
| 90716 |
|
199 |
193 |
$0.00 |
| 4010F |
|
56 |
51 |
$0.00 |
| 91307 |
|
78 |
71 |
$0.00 |
| 1101F |
|
30 |
30 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
53 |
52 |
$0.00 |
| 90696 |
|
18 |
16 |
$0.00 |
| 90651 |
|
24 |
24 |
$0.00 |
| 1123F |
|
18 |
14 |
$0.00 |
| 90710 |
|
228 |
213 |
$0.00 |
| 3078F |
|
10,003 |
8,320 |
$0.00 |
| 1159F |
|
21,847 |
17,728 |
$0.00 |
| 90633 |
|
2,200 |
2,118 |
$0.00 |
| 90648 |
|
971 |
955 |
$0.00 |
| 3725F |
|
50 |
42 |
$0.00 |
| 99177 |
|
102 |
96 |
$0.00 |
| 0502F |
|
255 |
181 |
$0.00 |
| 90681 |
|
179 |
177 |
$0.00 |
| 99173 |
|
137 |
129 |
$0.00 |
| 90707 |
|
203 |
197 |
$0.00 |
| 90700 |
|
41 |
41 |
$0.00 |
| 99497 |
|
62 |
41 |
$0.00 |
| 3077F |
|
25 |
24 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
53 |
44 |
$0.00 |
| 90662 |
|
12 |
12 |
$0.00 |
| 90671 |
|
26 |
26 |
$0.00 |
| 91308 |
|
14 |
12 |
$0.00 |
| 1160F |
|
30 |
29 |
$0.00 |