| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50,034 |
44,497 |
$3.39M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,162 |
34,885 |
$1.83M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,375 |
6,116 |
$403K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,227 |
10,030 |
$329K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,743 |
3,658 |
$280K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,197 |
2,849 |
$264K |
| 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 |
3,105 |
3,014 |
$256K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,858 |
2,795 |
$244K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,229 |
3,187 |
$230K |
| 99215 |
Prolong outpt/office vis |
2,243 |
2,080 |
$217K |
| X5622 |
|
4,338 |
4,183 |
$213K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,385 |
2,361 |
$173K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,832 |
1,764 |
$170K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,371 |
2,334 |
$151K |
| 36415 |
Collection of venous blood by venipuncture |
31,548 |
28,947 |
$108K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,679 |
2,444 |
$103K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
13,526 |
13,336 |
$92K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,106 |
987 |
$92K |
| 92015 |
Determination of refractive state |
7,910 |
7,740 |
$90K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,710 |
3,646 |
$86K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,054 |
1,034 |
$81K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,254 |
2,151 |
$77K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,243 |
2,141 |
$76K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,345 |
5,149 |
$75K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,191 |
2,120 |
$66K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,732 |
7,462 |
$66K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
923 |
871 |
$63K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,391 |
1,282 |
$59K |
| 80061 |
Lipid panel |
4,641 |
4,515 |
$58K |
| 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 |
2,430 |
2,366 |
$57K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,344 |
1,312 |
$51K |
| 92551 |
|
7,137 |
7,018 |
$48K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,653 |
1,604 |
$46K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
642 |
598 |
$46K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
692 |
637 |
$45K |
| V2020 |
Frames, purchases |
2,099 |
1,707 |
$45K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,161 |
1,102 |
$44K |
| 90686 |
|
7,376 |
7,195 |
$44K |
| 99188 |
|
4,026 |
3,986 |
$44K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,620 |
2,540 |
$41K |
| 99243 |
|
429 |
420 |
$39K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,092 |
3,938 |
$38K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,710 |
1,638 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,703 |
864 |
$34K |
| 92567 |
|
3,049 |
2,861 |
$29K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
567 |
471 |
$29K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,649 |
4,394 |
$28K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,160 |
1,117 |
$28K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,603 |
3,472 |
$28K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
908 |
827 |
$27K |
| 91322 |
|
212 |
208 |
$26K |
| 80053 |
Comprehensive metabolic panel |
2,434 |
2,372 |
$25K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
595 |
570 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,418 |
3,189 |
$20K |
| 92557 |
|
812 |
767 |
$20K |
| 71046 |
Radiologic examination, chest; 2 views |
1,259 |
1,155 |
$19K |
| 86780 |
|
1,239 |
1,190 |
$16K |
| 90651 |
|
745 |
726 |
$16K |
| 73630 |
|
737 |
592 |
$16K |
| A7035 |
Headgear used with positive airway pressure device |
676 |
614 |
$14K |
| 0002A |
|
397 |
393 |
$13K |
| 97810 |
|
512 |
273 |
$13K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
465 |
450 |
$13K |
| 85027 |
|
2,041 |
1,969 |
$12K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,574 |
1,515 |
$12K |
| 97811 |
|
513 |
273 |
$12K |
| 81514 |
|
41 |
41 |
$11K |
| 90480 |
|
477 |
472 |
$11K |
| A7031 |
Face mask interface, replacement for full face mask, each |
218 |
204 |
$10K |
| 81025 |
|
1,527 |
1,449 |
$10K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
303 |
254 |
$10K |
| 92341 |
|
315 |
306 |
$10K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
27 |
25 |
$10K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
143 |
140 |
$9K |
| 90715 |
|
635 |
620 |
$9K |
| 81001 |
|
3,367 |
3,176 |
$9K |
| 99173 |
|
5,968 |
5,863 |
$9K |
| 86803 |
|
576 |
564 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,197 |
988 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
948 |
460 |
$8K |
| 0001A |
|
320 |
316 |
$8K |
| 87210 |
|
1,821 |
1,743 |
$8K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
111 |
107 |
$8K |
| 99177 |
|
1,457 |
1,438 |
$8K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
201 |
197 |
$7K |
| 0054A |
|
169 |
168 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,081 |
1,070 |
$7K |
| 0071A |
|
199 |
160 |
$6K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
83 |
79 |
$6K |
| 0072A |
|
157 |
153 |
$6K |
| 90670 |
|
1,760 |
1,722 |
$6K |
| 0124A |
|
180 |
168 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
59 |
50 |
$6K |
| 80047 |
|
621 |
588 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
518 |
477 |
$6K |
| 87081 |
|
1,871 |
1,813 |
$6K |
| 96127 |
|
1,425 |
1,409 |
$5K |
| 90691 |
|
42 |
42 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
239 |
224 |
$5K |
| 87481 |
|
122 |
118 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
114 |
111 |
$4K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
527 |
477 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
299 |
289 |
$4K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
27 |
27 |
$4K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
101 |
90 |
$4K |
| 85018 |
|
1,471 |
1,435 |
$3K |
| 31575 |
|
30 |
30 |
$3K |
| 0004A |
|
85 |
80 |
$3K |
| 93000 |
|
314 |
295 |
$2K |
| 17110 |
|
44 |
42 |
$2K |
| 0012A |
|
83 |
83 |
$2K |
| 0011A |
|
88 |
87 |
$2K |
| 90656 |
|
208 |
208 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
186 |
177 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
35 |
26 |
$2K |
| 80076 |
|
214 |
203 |
$2K |
| 0031A |
|
78 |
60 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
322 |
295 |
$2K |
| 31231 |
|
12 |
12 |
$1K |
| 82728 |
|
101 |
101 |
$1K |
| 90694 |
|
31 |
31 |
$1K |
| 69210 |
|
44 |
43 |
$1K |
| 0051A |
|
33 |
33 |
$1K |
| 0052A |
|
31 |
31 |
$1K |
| 99000 |
|
362 |
341 |
$1K |
| 87340 |
|
120 |
115 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
13 |
$1K |
| 81003 |
|
771 |
736 |
$1K |
| 92587 |
|
80 |
73 |
$1K |
| 90653 |
|
12 |
12 |
$1K |
| 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) |
69 |
63 |
$998.21 |
| 90716 |
|
913 |
903 |
$958.16 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$952.08 |
| 90707 |
|
641 |
637 |
$889.23 |
| 82043 |
|
138 |
137 |
$805.50 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
79 |
44 |
$800.66 |
| 82248 |
|
161 |
150 |
$707.10 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
28 |
12 |
$622.71 |
| 90677 |
|
191 |
191 |
$571.36 |
| 90734 |
|
370 |
365 |
$552.17 |
| 87186 |
|
55 |
51 |
$516.89 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
53 |
50 |
$463.95 |
| 87077 |
|
52 |
41 |
$451.67 |
| 90714 |
|
14 |
14 |
$379.24 |
| 92593 |
|
12 |
12 |
$336.91 |
| 36416 |
|
113 |
106 |
$298.58 |
| 83550 |
|
28 |
27 |
$257.27 |
| 83540 |
|
29 |
28 |
$197.23 |
| 82607 |
|
12 |
12 |
$186.39 |
| 87338 |
|
12 |
12 |
$180.87 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
26 |
26 |
$150.00 |
| 99401 |
|
13 |
13 |
$135.90 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
25 |
25 |
$113.68 |
| 82565 |
|
15 |
15 |
$82.80 |
| 85652 |
|
28 |
26 |
$78.03 |
| 86140 |
|
13 |
13 |
$66.48 |
| 85651 |
|
40 |
38 |
$59.41 |
| 90647 |
|
1,191 |
1,148 |
$54.18 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
38 |
37 |
$25.46 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
27 |
12 |
$12.84 |
| 90633 |
|
860 |
836 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
526 |
487 |
$0.00 |
| 91300 |
|
20 |
16 |
$0.00 |
| 91321 |
|
75 |
75 |
$0.00 |
| 90681 |
|
154 |
141 |
$0.00 |
| 90700 |
|
40 |
38 |
$0.00 |
| 82947 |
|
12 |
12 |
$0.00 |
| 90723 |
|
1,375 |
1,327 |
$0.00 |
| 90696 |
|
87 |
87 |
$0.00 |
| 90688 |
|
15 |
15 |
$0.00 |