| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
997 |
884 |
$88K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,150 |
1,100 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,050 |
1,875 |
$67K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,621 |
1,570 |
$66K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,739 |
7,135 |
$55K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,144 |
1,104 |
$51K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,086 |
364 |
$50K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
179 |
179 |
$18K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
163 |
163 |
$14K |
| 59425 |
|
255 |
160 |
$14K |
| A4267 |
Contraceptive supply, condom, male, each |
95 |
91 |
$13K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,314 |
2,292 |
$13K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
83 |
79 |
$12K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
79 |
72 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,435 |
1,355 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
951 |
910 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
213 |
210 |
$8K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
222 |
99 |
$6K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
121 |
118 |
$6K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
148 |
147 |
$6K |
| 97803 |
|
3,000 |
2,704 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
443 |
421 |
$6K |
| 70450 |
Computed tomography, head or brain; without contrast material |
142 |
125 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
732 |
684 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
462 |
373 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
133 |
131 |
$4K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
58 |
57 |
$4K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
424 |
383 |
$4K |
| 97802 |
|
1,983 |
1,922 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
270 |
241 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
314 |
267 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,285 |
1,150 |
$3K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13 |
13 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
68 |
59 |
$2K |
| 76830 |
Ultrasound, transvaginal |
53 |
50 |
$2K |
| 80053 |
Comprehensive metabolic panel |
3,259 |
3,152 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
25 |
25 |
$2K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
12 |
12 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
13 |
12 |
$2K |
| 99215 |
Prolong outpt/office vis |
76 |
73 |
$1K |
| T4541 |
Incontinence product, disposable underpad, large, each |
84 |
84 |
$1K |
| 76641 |
|
22 |
12 |
$1K |
| 85018 |
|
2,215 |
2,083 |
$906.84 |
| 73630 |
|
105 |
79 |
$877.32 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
44 |
44 |
$852.46 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
529 |
406 |
$841.44 |
| 88142 |
|
173 |
173 |
$750.96 |
| 81025 |
|
372 |
342 |
$722.73 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,687 |
1,606 |
$707.75 |
| J3490 |
Unclassified drugs |
12 |
12 |
$698.79 |
| 97161 |
|
13 |
13 |
$623.26 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
40 |
$548.26 |
| A0425 |
Ground mileage, per statute mile |
353 |
297 |
$515.12 |
| 80076 |
|
199 |
162 |
$462.81 |
| 71020 |
|
85 |
43 |
$432.62 |
| 90651 |
|
189 |
156 |
$417.16 |
| 73610 |
|
69 |
59 |
$377.22 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
16 |
15 |
$376.29 |
| 87806 |
|
78 |
78 |
$367.49 |
| 3008F |
|
2,839 |
2,634 |
$353.00 |
| 81001 |
|
1,530 |
1,492 |
$336.46 |
| 99000 |
|
581 |
559 |
$324.52 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,858 |
3,620 |
$287.64 |
| 73030 |
|
27 |
27 |
$286.55 |
| 73562 |
|
17 |
14 |
$261.14 |
| 83970 |
|
26 |
25 |
$250.76 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
104 |
101 |
$235.46 |
| 85610 |
|
305 |
265 |
$215.43 |
| 74018 |
|
18 |
16 |
$212.74 |
| 73110 |
|
18 |
17 |
$208.04 |
| 82728 |
|
73 |
71 |
$196.93 |
| 73130 |
|
17 |
13 |
$160.41 |
| 80061 |
Lipid panel |
2,620 |
2,596 |
$154.07 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
467 |
462 |
$153.00 |
| 85027 |
|
584 |
548 |
$146.17 |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
15 |
15 |
$137.55 |
| 81000 |
|
2,107 |
1,904 |
$123.54 |
| 87081 |
|
87 |
86 |
$112.13 |
| 84484 |
|
122 |
100 |
$110.13 |
| 36415 |
Collection of venous blood by venipuncture |
2,984 |
2,865 |
$104.02 |
| 87040 |
|
14 |
12 |
$103.47 |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,102 |
2,067 |
$96.20 |
| 99233 |
Prolong inpt eval add15 m |
30 |
12 |
$91.21 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,310 |
2,288 |
$75.23 |
| 92081 |
|
812 |
812 |
$75.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
247 |
247 |
$69.08 |
| 90658 |
|
227 |
226 |
$65.00 |
| 85730 |
|
174 |
163 |
$63.08 |
| 83735 |
|
19 |
13 |
$60.14 |
| 73080 |
|
15 |
14 |
$59.38 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
631 |
613 |
$57.56 |
| 87077 |
|
202 |
197 |
$51.77 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,104 |
2,082 |
$50.63 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
762 |
733 |
$48.50 |
| 84702 |
|
232 |
183 |
$48.15 |
| 87110 |
|
778 |
696 |
$48.00 |
| 81003 |
|
327 |
319 |
$35.84 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
4,461 |
4,154 |
$34.00 |
| 83690 |
|
175 |
165 |
$33.78 |
| 11721 |
|
53 |
53 |
$33.51 |
| 83540 |
|
132 |
129 |
$31.90 |
| 87070 |
|
431 |
429 |
$30.11 |
| 86592 |
|
894 |
880 |
$30.06 |
| 84703 |
|
86 |
84 |
$27.53 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
719 |
716 |
$26.53 |
| 84100 |
|
35 |
28 |
$25.26 |
| 90461 |
|
576 |
550 |
$25.00 |
| 87210 |
|
12 |
12 |
$24.86 |
| 3077F |
|
158 |
154 |
$24.00 |
| 1159F |
|
2,000 |
1,830 |
$24.00 |
| 82550 |
|
16 |
13 |
$17.52 |
| 80320 |
|
12 |
12 |
$13.93 |
| 87186 |
|
191 |
185 |
$9.68 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$9.62 |
| 90620 |
|
12 |
12 |
$9.00 |
| 90686 |
|
188 |
188 |
$9.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
517 |
517 |
$9.00 |
| 87147 |
|
133 |
132 |
$6.13 |
| 82785 |
|
225 |
223 |
$2.92 |
| 87088 |
|
475 |
467 |
$2.64 |
| 86901 |
|
17 |
15 |
$2.46 |
| 86140 |
|
159 |
132 |
$2.38 |
| 81002 |
|
706 |
701 |
$0.86 |
| 3079F |
|
320 |
308 |
$0.00 |
| 3074F |
|
1,222 |
1,141 |
$0.00 |
| 1125F |
|
392 |
374 |
$0.00 |
| 82607 |
|
86 |
84 |
$0.00 |
| 92551 |
|
1,188 |
1,188 |
$0.00 |
| 83021 |
|
251 |
251 |
$0.00 |
| 36416 |
|
446 |
446 |
$0.00 |
| 2010F |
|
180 |
176 |
$0.00 |
| 82043 |
|
477 |
475 |
$0.00 |
| 83001 |
|
28 |
28 |
$0.00 |
| 3075F |
|
128 |
120 |
$0.00 |
| 96151 |
|
104 |
104 |
$0.00 |
| 83002 |
|
26 |
26 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
104 |
39 |
$0.00 |
| 83550 |
|
146 |
143 |
$0.00 |
| E0570 |
Nebulizer, with compressor |
13 |
13 |
$0.00 |
| 90698 |
|
89 |
89 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
222 |
222 |
$0.00 |
| 1126F |
|
630 |
599 |
$0.00 |
| 84436 |
|
542 |
522 |
$0.00 |
| 84153 |
|
251 |
249 |
$0.00 |
| 20553 |
|
172 |
171 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
122 |
119 |
$0.00 |
| 3044F |
|
15 |
15 |
$0.00 |
| 94760 |
|
12 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
185 |
177 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
43 |
43 |
$0.00 |
| 82950 |
|
54 |
53 |
$0.00 |
| 85652 |
|
188 |
165 |
$0.00 |
| 86803 |
|
12 |
12 |
$0.00 |
| 1170F |
|
38 |
38 |
$0.00 |
| 1000F |
|
39 |
38 |
$0.00 |
| 80081 |
|
28 |
28 |
$0.00 |
| 84479 |
|
329 |
329 |
$0.00 |
| 86580 |
|
81 |
81 |
$0.00 |
| 1111F |
|
26 |
26 |
$0.00 |
| 82746 |
|
14 |
13 |
$0.00 |
| 82044 |
|
14 |
14 |
$0.00 |
| 93000 |
|
13 |
13 |
$0.00 |
| 82962 |
|
13 |
13 |
$0.00 |
| 92552 |
|
1,463 |
1,327 |
$0.00 |
| 82570 |
|
506 |
503 |
$0.00 |
| 84460 |
|
12 |
12 |
$0.00 |
| 1160F |
|
1,408 |
1,307 |
$0.00 |
| 3078F |
|
1,282 |
1,196 |
$0.00 |
| 82948 |
|
90 |
87 |
$0.00 |
| 83525 |
|
128 |
128 |
$0.00 |
| 82652 |
|
50 |
50 |
$0.00 |
| 1158F |
|
175 |
173 |
$0.00 |
| 99173 |
|
1,341 |
1,204 |
$0.00 |
| 90670 |
|
104 |
104 |
$0.00 |
| 3725F |
|
220 |
220 |
$0.00 |
| 83655 |
|
726 |
703 |
$0.00 |
| 86038 |
|
103 |
102 |
$0.00 |
| 86003 |
|
241 |
241 |
$0.00 |
| 86431 |
|
142 |
142 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
300 |
296 |
$0.00 |
| 84481 |
|
65 |
64 |
$0.00 |
| 82947 |
|
235 |
234 |
$0.00 |
| 90649 |
|
128 |
128 |
$0.00 |
| 82274 |
|
167 |
147 |
$0.00 |
| 84403 |
|
12 |
12 |
$0.00 |
| 82465 |
|
125 |
125 |
$0.00 |
| 90710 |
|
38 |
38 |
$0.00 |
| 82248 |
|
19 |
19 |
$0.00 |
| 84439 |
|
315 |
310 |
$0.00 |
| 84550 |
|
417 |
417 |
$0.00 |
| 80074 |
|
63 |
63 |
$0.00 |
| 90685 |
|
32 |
32 |
$0.00 |
| 90734 |
|
49 |
37 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
44 |
44 |
$0.00 |
| 99408 |
|
38 |
37 |
$0.00 |
| 90633 |
|
40 |
40 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
18 |
$0.00 |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
16 |
16 |
$0.00 |
| 0521F |
|
12 |
12 |
$0.00 |