| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
145 |
135 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,240 |
7,278 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,017 |
1,009 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,003 |
995 |
$2K |
| 80053 |
Comprehensive metabolic panel |
3,916 |
3,819 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
5,086 |
4,777 |
$811.29 |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,156 |
3,132 |
$357.17 |
| 80061 |
Lipid panel |
3,813 |
3,798 |
$298.10 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
884 |
855 |
$203.90 |
| 81001 |
|
2,317 |
2,268 |
$167.86 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,718 |
2,703 |
$152.93 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
48 |
46 |
$152.75 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
445 |
444 |
$141.00 |
| 86592 |
|
753 |
748 |
$105.15 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,221 |
1,218 |
$76.67 |
| 81003 |
|
1,042 |
1,040 |
$49.82 |
| 84439 |
|
907 |
903 |
$47.55 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
533 |
443 |
$41.90 |
| 83690 |
|
12 |
12 |
$41.16 |
| 84436 |
|
361 |
361 |
$24.08 |
| 82043 |
|
914 |
910 |
$23.82 |
| 82570 |
|
927 |
919 |
$21.44 |
| 86803 |
|
482 |
481 |
$12.44 |
| 87340 |
|
513 |
512 |
$9.03 |
| 80076 |
|
360 |
357 |
$8.44 |
| 3078F |
|
1,197 |
1,097 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
31 |
31 |
$0.00 |
| 86038 |
|
119 |
115 |
$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 |
152 |
152 |
$0.00 |
| 82274 |
|
148 |
146 |
$0.00 |
| 59425 |
|
292 |
212 |
$0.00 |
| 80305 |
|
53 |
52 |
$0.00 |
| 86708 |
|
130 |
130 |
$0.00 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
30 |
28 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
255 |
235 |
$0.00 |
| 84702 |
|
82 |
66 |
$0.00 |
| 82465 |
|
99 |
99 |
$0.00 |
| 84550 |
|
787 |
787 |
$0.00 |
| 82947 |
|
270 |
269 |
$0.00 |
| 1160F |
|
1,442 |
1,316 |
$0.00 |
| 83655 |
|
219 |
216 |
$0.00 |
| 86709 |
|
113 |
113 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
29 |
29 |
$0.00 |
| 90658 |
|
36 |
36 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
40 |
40 |
$0.00 |
| 84481 |
|
224 |
224 |
$0.00 |
| 81002 |
|
177 |
176 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
28 |
27 |
$0.00 |
| 1159F |
|
1,765 |
1,584 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
178 |
175 |
$0.00 |
| 86003 |
|
20 |
12 |
$0.00 |
| 87186 |
|
201 |
194 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
89 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
41 |
$0.00 |
| 86431 |
|
40 |
40 |
$0.00 |
| 85610 |
|
213 |
193 |
$0.00 |
| 86703 |
|
406 |
403 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$0.00 |
| 3077F |
|
111 |
100 |
$0.00 |
| 83721 |
|
61 |
61 |
$0.00 |
| 92552 |
|
12 |
12 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
12 |
12 |
$0.00 |
| 84100 |
|
41 |
16 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
55 |
55 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
79 |
79 |
$0.00 |
| 83540 |
|
28 |
27 |
$0.00 |
| 81025 |
|
66 |
63 |
$0.00 |
| 99223 |
Prolong inpt eval add15 m |
13 |
13 |
$0.00 |
| 97803 |
|
12 |
12 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
46 |
12 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| 86706 |
|
363 |
363 |
$0.00 |
| 81000 |
|
56 |
56 |
$0.00 |
| 84480 |
|
170 |
170 |
$0.00 |
| 3074F |
|
1,346 |
1,237 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
397 |
385 |
$0.00 |
| 92551 |
|
414 |
414 |
$0.00 |
| 85651 |
|
331 |
331 |
$0.00 |
| 3079F |
|
42 |
39 |
$0.00 |
| 84479 |
|
124 |
124 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
152 |
152 |
$0.00 |
| 84153 |
|
398 |
398 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
176 |
164 |
$0.00 |
| 86141 |
|
159 |
159 |
$0.00 |
| 3008F |
|
2,395 |
2,211 |
$0.00 |
| 82105 |
|
13 |
13 |
$0.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
42 |
42 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
256 |
245 |
$0.00 |
| 82607 |
|
157 |
157 |
$0.00 |
| 87070 |
|
161 |
161 |
$0.00 |
| 80055 |
|
13 |
13 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
215 |
203 |
$0.00 |
| 85730 |
|
151 |
139 |
$0.00 |
| 3075F |
|
58 |
53 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
16 |
$0.00 |
| 86580 |
|
110 |
110 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
412 |
412 |
$0.00 |
| 85018 |
|
220 |
219 |
$0.00 |
| 99000 |
|
340 |
329 |
$0.00 |
| 82378 |
|
44 |
41 |
$0.00 |
| 84703 |
|
27 |
27 |
$0.00 |
| 3080F |
|
122 |
106 |
$0.00 |
| 1125F |
|
110 |
102 |
$0.00 |
| 83735 |
|
125 |
43 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
117 |
117 |
$0.00 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
75 |
74 |
$0.00 |
| 90686 |
|
15 |
15 |
$0.00 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
26 |
26 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 90651 |
|
28 |
28 |
$0.00 |
| 80050 |
General health panel |
70 |
70 |
$0.00 |
| 86140 |
|
12 |
12 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
31 |
30 |
$0.00 |
| 36410 |
|
27 |
27 |
$0.00 |
| 83550 |
|
28 |
27 |
$0.00 |
| 86704 |
|
13 |
13 |
$0.00 |
| 99243 |
|
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
17 |
17 |
$0.00 |
| 82728 |
|
28 |
25 |
$0.00 |
| 99050 |
|
20 |
19 |
$0.00 |