| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
37,520 |
34,652 |
$137K |
| 97802 |
|
14,558 |
14,526 |
$54K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,423 |
3,405 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,701 |
2,672 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,635 |
3,621 |
$29K |
| 90651 |
|
2,126 |
2,126 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,178 |
4,051 |
$18K |
| 92551 |
|
9,617 |
9,611 |
$16K |
| 96151 |
|
7,147 |
7,147 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
385 |
370 |
$9K |
| 90686 |
|
4,391 |
4,387 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,246 |
1,243 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
315 |
284 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,633 |
2,456 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
696 |
695 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,318 |
1,278 |
$5K |
| 97803 |
|
602 |
602 |
$4K |
| 90670 |
|
1,088 |
1,088 |
$3K |
| 90648 |
|
1,054 |
1,052 |
$3K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,210 |
5,208 |
$3K |
| 99000 |
|
9,206 |
8,668 |
$3K |
| 85018 |
|
11,260 |
11,169 |
$3K |
| 90734 |
|
1,592 |
1,592 |
$2K |
| 81002 |
|
10,077 |
9,972 |
$2K |
| 90723 |
|
490 |
490 |
$2K |
| 90633 |
|
604 |
604 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
26 |
26 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
740 |
709 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
686 |
686 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
7,109 |
6,858 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,691 |
4,674 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
67 |
66 |
$864.05 |
| 90715 |
|
474 |
474 |
$729.66 |
| 93000 |
|
319 |
319 |
$700.44 |
| 3008F |
|
48,013 |
44,530 |
$643.50 |
| 90620 |
|
618 |
616 |
$636.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
401 |
401 |
$610.92 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,845 |
4,840 |
$570.80 |
| 96150 |
|
631 |
631 |
$554.34 |
| 86580 |
|
564 |
563 |
$515.02 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
98 |
90 |
$441.18 |
| 99381 |
|
15 |
15 |
$359.04 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,279 |
1,244 |
$333.44 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18 |
13 |
$263.43 |
| 90710 |
|
139 |
139 |
$262.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14 |
12 |
$257.35 |
| 86592 |
|
423 |
423 |
$249.54 |
| 3074F |
|
15,695 |
15,478 |
$218.40 |
| 3078F |
|
15,190 |
14,970 |
$212.10 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
30 |
30 |
$205.66 |
| 90716 |
|
51 |
51 |
$199.00 |
| 90696 |
|
107 |
107 |
$183.00 |
| 83655 |
|
278 |
261 |
$178.84 |
| 80053 |
Comprehensive metabolic panel |
905 |
882 |
$176.38 |
| 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 |
16 |
15 |
$175.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
947 |
946 |
$128.08 |
| 90698 |
|
29 |
29 |
$99.00 |
| 90681 |
|
24 |
24 |
$99.00 |
| 4120F |
|
7,893 |
7,713 |
$94.20 |
| A4649 |
Surgical supply; miscellaneous |
47 |
31 |
$69.39 |
| 90707 |
|
37 |
37 |
$65.00 |
| 90461 |
|
1,824 |
1,824 |
$62.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
85 |
85 |
$60.00 |
| 90700 |
|
41 |
41 |
$55.00 |
| 90744 |
|
13 |
13 |
$54.00 |
| 81025 |
|
380 |
375 |
$49.64 |
| 3352F |
|
2,575 |
2,574 |
$46.80 |
| 99441 |
|
10,673 |
9,351 |
$41.04 |
| 90656 |
|
120 |
120 |
$36.00 |
| 99173 |
|
13,243 |
13,229 |
$31.08 |
| 3351F |
|
1,057 |
1,057 |
$28.50 |
| G0008 |
Administration of influenza virus vaccine |
486 |
486 |
$19.00 |
| 99442 |
|
1,364 |
1,278 |
$18.86 |
| 3079F |
|
2,239 |
2,190 |
$17.70 |
| 3725F |
|
401 |
401 |
$14.70 |
| 82947 |
|
431 |
420 |
$12.42 |
| 3044F |
|
708 |
693 |
$12.00 |
| 96127 |
|
156 |
156 |
$9.52 |
| 80061 |
Lipid panel |
1,033 |
1,027 |
$8.83 |
| 3075F |
|
1,033 |
1,023 |
$6.30 |
| 3048F |
|
232 |
229 |
$3.90 |
| 3353F |
|
347 |
346 |
$3.30 |
| 1220F |
|
334 |
334 |
$2.70 |
| 3077F |
|
698 |
667 |
$2.40 |
| 4010F |
|
341 |
324 |
$0.90 |
| 3050F |
|
131 |
122 |
$0.60 |
| 1170F |
|
155 |
153 |
$0.30 |
| 3080F |
|
280 |
264 |
$0.30 |
| 1157F |
|
33 |
33 |
$0.30 |
| 3015F |
|
189 |
179 |
$0.30 |
| 1160F |
|
332 |
324 |
$0.30 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
357 |
356 |
$0.00 |
| 86695 |
|
75 |
74 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
726 |
698 |
$0.00 |
| 96156 |
|
1,809 |
1,809 |
$0.00 |
| 3049F |
|
171 |
164 |
$0.00 |
| 81001 |
|
375 |
369 |
$0.00 |
| 99156 |
|
34 |
34 |
$0.00 |
| 1036F |
|
704 |
704 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
854 |
851 |
$0.00 |
| 87070 |
|
16 |
16 |
$0.00 |
| 1126F |
|
191 |
191 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
756 |
754 |
$0.00 |
| 1000F |
|
76 |
75 |
$0.00 |
| 57410 |
|
86 |
86 |
$0.00 |
| 3017F |
|
12 |
12 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
15 |
$0.00 |
| 4140F |
|
24 |
24 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
184 |
184 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
27 |
27 |
$0.00 |
| 1125F |
|
76 |
74 |
$0.00 |
| 20553 |
|
13 |
13 |
$0.00 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
13 |
13 |
$0.00 |
| 84436 |
|
14 |
14 |
$0.00 |
| 3354F |
|
12 |
12 |
$0.00 |
| 96160 |
|
9,137 |
9,137 |
$0.00 |
| 92552 |
|
15 |
15 |
$0.00 |
| 84439 |
|
132 |
131 |
$0.00 |
| 1159F |
|
397 |
392 |
$0.00 |
| 4124F |
|
143 |
140 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
26 |
25 |
$0.00 |
| 86696 |
|
74 |
74 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
65 |
65 |
$0.00 |
| 1158F |
|
25 |
25 |
$0.00 |
| 82565 |
|
12 |
12 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
64 |
64 |
$0.00 |
| 84520 |
|
12 |
12 |
$0.00 |
| G9920 |
Screening performed and negative |
16 |
16 |
$0.00 |