| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,261 |
1,188 |
$61K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
511 |
468 |
$56K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
696 |
668 |
$48K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,872 |
7,726 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
586 |
567 |
$20K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
395 |
112 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
347 |
346 |
$12K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
262 |
260 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
214 |
214 |
$12K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
566 |
555 |
$11K |
| 59425 |
|
196 |
118 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
483 |
483 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
90 |
90 |
$8K |
| 99223 |
Prolong inpt eval add15 m |
47 |
38 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
155 |
124 |
$7K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
46 |
41 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
73 |
73 |
$6K |
| J3490 |
Unclassified drugs |
83 |
74 |
$6K |
| 80053 |
Comprehensive metabolic panel |
2,089 |
2,013 |
$5K |
| 99243 |
|
64 |
64 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
128 |
119 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,372 |
3,106 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
271 |
271 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,230 |
2,970 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
456 |
350 |
$4K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
69 |
69 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
32 |
30 |
$2K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
16 |
15 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
64 |
60 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
82 |
81 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
25 |
24 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
181 |
175 |
$2K |
| 99233 |
Prolong inpt eval add15 m |
37 |
12 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
561 |
549 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
687 |
648 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
543 |
477 |
$2K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
293 |
240 |
$2K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
176 |
55 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
46 |
44 |
$977.40 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
33 |
31 |
$856.15 |
| T4541 |
Incontinence product, disposable underpad, large, each |
25 |
25 |
$733.99 |
| 81001 |
|
1,042 |
1,018 |
$716.87 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,272 |
1,268 |
$676.46 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
70 |
70 |
$639.61 |
| 81025 |
|
177 |
168 |
$545.68 |
| 90649 |
|
84 |
83 |
$540.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
15 |
15 |
$477.14 |
| 81003 |
|
1,239 |
1,229 |
$436.50 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
560 |
543 |
$426.04 |
| 72100 |
|
26 |
26 |
$377.18 |
| 80076 |
|
350 |
342 |
$350.45 |
| 80061 |
Lipid panel |
1,847 |
1,840 |
$348.88 |
| 86703 |
|
265 |
265 |
$313.65 |
| 80305 |
|
25 |
25 |
$250.92 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,065 |
1,057 |
$247.42 |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,561 |
1,549 |
$239.24 |
| 3008F |
|
438 |
401 |
$198.00 |
| 86580 |
|
108 |
107 |
$197.60 |
| 85018 |
|
1,291 |
1,288 |
$180.52 |
| A0425 |
Ground mileage, per statute mile |
209 |
176 |
$178.61 |
| 86592 |
|
297 |
294 |
$156.18 |
| 87070 |
|
303 |
294 |
$151.08 |
| 73610 |
|
24 |
24 |
$140.08 |
| 73080 |
|
17 |
13 |
$136.66 |
| 86003 |
|
14 |
13 |
$131.60 |
| 90651 |
|
51 |
51 |
$126.00 |
| 85730 |
|
117 |
100 |
$104.98 |
| 73562 |
|
15 |
13 |
$97.72 |
| 90686 |
|
97 |
97 |
$90.00 |
| 90688 |
|
86 |
86 |
$81.00 |
| 74018 |
|
16 |
15 |
$70.92 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
561 |
561 |
$62.73 |
| 84480 |
|
343 |
343 |
$62.73 |
| 83655 |
|
517 |
516 |
$49.27 |
| 83690 |
|
119 |
106 |
$47.44 |
| 84703 |
|
110 |
106 |
$45.43 |
| 85610 |
|
207 |
187 |
$44.14 |
| 82274 |
|
81 |
80 |
$41.60 |
| 90620 |
|
13 |
13 |
$36.00 |
| 84439 |
|
674 |
672 |
$31.21 |
| 90734 |
|
13 |
13 |
$27.00 |
| 84484 |
|
47 |
42 |
$26.93 |
| 81002 |
|
763 |
717 |
$25.88 |
| 92552 |
|
395 |
394 |
$25.16 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
82 |
81 |
$24.24 |
| 36415 |
Collection of venous blood by venipuncture |
159 |
157 |
$24.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
17 |
16 |
$20.48 |
| 99173 |
|
525 |
525 |
$16.16 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$14.00 |
| 84702 |
|
49 |
40 |
$13.24 |
| 92081 |
|
466 |
466 |
$9.00 |
| 85651 |
|
162 |
160 |
$8.69 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
20 |
18 |
$7.27 |
| 84550 |
|
301 |
300 |
$6.42 |
| 86140 |
|
120 |
108 |
$5.11 |
| 82728 |
|
82 |
79 |
$4.58 |
| 84460 |
|
38 |
38 |
$4.58 |
| 87186 |
|
167 |
159 |
$3.02 |
| 87040 |
|
12 |
12 |
$1.80 |
| 82043 |
|
246 |
245 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
676 |
655 |
$0.00 |
| 92551 |
|
835 |
833 |
$0.00 |
| 84153 |
|
191 |
190 |
$0.00 |
| 99000 |
|
723 |
693 |
$0.00 |
| 92060 |
|
309 |
309 |
$0.00 |
| 84479 |
|
244 |
244 |
$0.00 |
| 81000 |
|
326 |
326 |
$0.00 |
| 97802 |
|
73 |
64 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
359 |
349 |
$0.00 |
| 83735 |
|
35 |
24 |
$0.00 |
| 3074F |
|
306 |
282 |
$0.00 |
| 86803 |
|
25 |
25 |
$0.00 |
| 84436 |
|
315 |
315 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
46 |
41 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
80 |
77 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
49 |
48 |
$0.00 |
| 83550 |
|
50 |
49 |
$0.00 |
| 82951 |
|
15 |
13 |
$0.00 |
| 97035 |
|
37 |
12 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
29 |
29 |
$0.00 |
| 1160F |
|
189 |
181 |
$0.00 |
| 1159F |
|
189 |
181 |
$0.00 |
| 92553 |
|
158 |
158 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
28 |
28 |
$0.00 |
| 84481 |
|
216 |
216 |
$0.00 |
| 3078F |
|
312 |
292 |
$0.00 |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
28 |
24 |
$0.00 |
| 86038 |
|
26 |
26 |
$0.00 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
36 |
12 |
$0.00 |
| 82947 |
|
95 |
91 |
$0.00 |
| 82570 |
|
257 |
255 |
$0.00 |
| 83540 |
|
52 |
51 |
$0.00 |
| 94664 |
|
33 |
33 |
$0.00 |
| 97803 |
|
28 |
28 |
$0.00 |
| 82948 |
|
15 |
12 |
$0.00 |
| 85014 |
|
25 |
25 |
$0.00 |