| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49,951 |
37,929 |
$2.58M |
| 99000 |
|
93,753 |
36,164 |
$1.08M |
| 95012 |
|
55,476 |
24,043 |
$848K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
59,216 |
24,482 |
$819K |
| 94010 |
|
30,042 |
24,025 |
$668K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,094 |
4,829 |
$403K |
| 98960 |
|
44,060 |
33,704 |
$360K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,668 |
4,195 |
$345K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,030 |
3,771 |
$338K |
| 96112 |
|
3,990 |
3,783 |
$307K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,873 |
6,923 |
$302K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,464 |
3,206 |
$299K |
| 36410 |
|
27,439 |
9,631 |
$274K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
23,338 |
9,814 |
$242K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15,585 |
13,662 |
$199K |
| 36406 |
|
21,752 |
6,673 |
$199K |
| 99215 |
Prolong outpt/office vis |
2,390 |
2,126 |
$182K |
| 95076 |
|
2,576 |
2,257 |
$173K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,055 |
1,934 |
$165K |
| 92081 |
|
16,965 |
15,528 |
$163K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
15,542 |
12,858 |
$158K |
| 83655 |
|
14,473 |
13,002 |
$142K |
| 80061 |
Lipid panel |
14,370 |
12,906 |
$124K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13,903 |
12,460 |
$105K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15,371 |
14,080 |
$98K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,162 |
2,021 |
$86K |
| 99441 |
|
3,427 |
2,695 |
$81K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,860 |
5,598 |
$70K |
| 97802 |
|
13,760 |
12,517 |
$48K |
| S9470 |
Nutritional counseling, dietitian visit |
1,872 |
1,624 |
$47K |
| 99381 |
|
685 |
635 |
$46K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
285 |
255 |
$43K |
| 92552 |
|
14,097 |
12,945 |
$38K |
| 96130 |
|
674 |
626 |
$36K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,436 |
1,331 |
$35K |
| 87430 |
|
2,943 |
2,571 |
$32K |
| 99205 |
Prolong outpt/office vis |
310 |
290 |
$32K |
| 99383 |
|
354 |
330 |
$30K |
| 90461 |
|
17,679 |
4,805 |
$29K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,152 |
2,012 |
$25K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
287 |
259 |
$22K |
| 87807 |
|
2,152 |
1,972 |
$22K |
| 99402 |
|
917 |
830 |
$19K |
| 99382 |
|
192 |
179 |
$17K |
| 90832 |
Psychotherapy, 30 minutes with patient |
260 |
126 |
$16K |
| 99384 |
|
127 |
120 |
$12K |
| 99051 |
|
1,605 |
1,388 |
$11K |
| 81002 |
|
4,014 |
3,529 |
$11K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
874 |
799 |
$10K |
| 99050 |
|
764 |
688 |
$10K |
| 80502 |
|
1,367 |
1,258 |
$10K |
| 99442 |
|
253 |
228 |
$8K |
| 99417 |
Prolong home eval add 15m |
901 |
814 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
146 |
142 |
$7K |
| 90671 |
|
1,002 |
966 |
$7K |
| 99354 |
|
214 |
190 |
$5K |
| 86580 |
|
931 |
895 |
$5K |
| 84443 |
Thyroid stimulating hormone (TSH) |
338 |
330 |
$4K |
| 80053 |
Comprehensive metabolic panel |
450 |
431 |
$4K |
| 96156 |
|
331 |
317 |
$4K |
| 99404 |
|
79 |
76 |
$3K |
| 96160 |
|
15,000 |
12,344 |
$3K |
| 94760 |
|
26,985 |
21,694 |
$3K |
| 90734 |
|
926 |
854 |
$3K |
| A9150 |
Non-prescription drugs |
3,418 |
3,033 |
$3K |
| 96158 |
|
332 |
318 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
30 |
29 |
$3K |
| 85027 |
|
1,132 |
1,093 |
$2K |
| 99078 |
|
183 |
170 |
$2K |
| 0001A |
|
51 |
51 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
289 |
276 |
$2K |
| 96161 |
|
6,596 |
5,512 |
$2K |
| 96131 |
|
22 |
22 |
$2K |
| 0002A |
|
41 |
41 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
131 |
121 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
446 |
428 |
$2K |
| 85014 |
|
1,274 |
1,208 |
$1K |
| 90688 |
|
422 |
416 |
$1K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
99 |
98 |
$617.38 |
| 92551 |
|
475 |
466 |
$601.41 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,918 |
2,514 |
$543.31 |
| 90651 |
|
944 |
873 |
$495.03 |
| 80503 |
|
90 |
65 |
$420.04 |
| 90733 |
|
13 |
13 |
$404.47 |
| 90715 |
|
549 |
504 |
$364.76 |
| 87420 |
|
63 |
55 |
$344.58 |
| 97803 |
|
197 |
168 |
$338.85 |
| 90620 |
|
376 |
365 |
$330.06 |
| 90670 |
|
2,279 |
2,152 |
$287.69 |
| 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) |
75 |
66 |
$269.50 |
| 84439 |
|
223 |
221 |
$234.28 |
| 90619 |
|
54 |
53 |
$177.53 |
| 82247 |
|
54 |
43 |
$162.02 |
| 83525 |
|
205 |
200 |
$159.36 |
| 85018 |
|
686 |
642 |
$147.65 |
| 82950 |
|
30 |
30 |
$125.71 |
| 90686 |
|
1,365 |
1,323 |
$83.36 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
14,262 |
11,771 |
$74.09 |
| 84436 |
|
154 |
153 |
$51.37 |
| 80076 |
|
19 |
18 |
$22.65 |
| 90633 |
|
1,712 |
1,612 |
$15.00 |
| 84479 |
|
15 |
14 |
$5.97 |
| 90707 |
|
573 |
568 |
$5.01 |
| 90716 |
|
594 |
588 |
$5.01 |
| 90648 |
|
1,277 |
1,210 |
$5.00 |
| 90696 |
|
524 |
504 |
$5.00 |
| 82248 |
|
34 |
26 |
$4.22 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
82 |
80 |
$3.93 |
| 90700 |
|
688 |
648 |
$2.70 |
| 90647 |
|
1,015 |
952 |
$2.70 |
| H0001 |
Alcohol and/or drug assessment |
334 |
326 |
$0.05 |
| G9923 |
Safety concerns screen provided and negative |
258 |
243 |
$0.01 |
| 90723 |
|
1,853 |
1,762 |
$0.01 |
| 6102F |
|
424 |
398 |
$0.00 |
| 99173 |
|
551 |
532 |
$0.00 |
| S9449 |
Weight management classes, non-physician provider, per session |
1,884 |
1,558 |
$0.00 |
| 91300 |
|
173 |
153 |
$0.00 |
| G8539 |
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
1,398 |
1,195 |
$0.00 |
| 4551F |
|
3,085 |
2,534 |
$0.00 |
| 90710 |
|
757 |
720 |
$0.00 |
| 3725F |
|
3,480 |
2,930 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
447 |
377 |
$0.00 |
| G0271 |
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), group (2 or more individuals), each 30 minutes |
867 |
794 |
$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 |
895 |
815 |
$0.00 |
| D0190 |
|
220 |
209 |
$0.00 |
| 3078F |
|
683 |
598 |
$0.00 |
| G0445 |
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes |
72 |
70 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
9,460 |
7,847 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
113 |
104 |
$0.00 |
| 90863 |
|
1,036 |
883 |
$0.00 |
| 99483 |
Prolong outpt/office vis |
41 |
39 |
$0.00 |
| 4120F |
|
176 |
150 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
106 |
104 |
$0.00 |
| 99401 |
|
290 |
232 |
$0.00 |
| 90785 |
|
196 |
179 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
90 |
81 |
$0.00 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
80 |
78 |
$0.00 |
| 84030 |
|
72 |
67 |
$0.00 |
| H2037 |
Developmental delay prevention activities, dependent child of client, per 15 minutes |
14 |
14 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
12 |
12 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
35 |
34 |
$0.00 |
| G8421 |
Bmi not documented and no reason is given |
15 |
14 |
$0.00 |
| J7614 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
45 |
44 |
$0.00 |
| 99411 |
|
17 |
17 |
$0.00 |
| G8476 |
Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg |
35 |
31 |
$0.00 |
| 3700F |
|
519 |
465 |
$0.00 |
| 96127 |
|
13,909 |
11,718 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
857 |
758 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
448 |
409 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,171 |
1,847 |
$0.00 |
| 92283 |
|
12,335 |
11,242 |
$0.00 |
| 4060F |
|
436 |
411 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
1,378 |
1,173 |
$0.00 |
| 1005F |
|
15 |
12 |
$0.00 |
| 99484 |
|
79 |
77 |
$0.00 |
| 90680 |
|
2,034 |
1,927 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
540 |
472 |
$0.00 |
| 1111F |
|
8,916 |
7,496 |
$0.00 |
| 90697 |
|
181 |
164 |
$0.00 |
| 99429 |
|
40 |
40 |
$0.00 |
| 2001F |
|
457 |
341 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
693 |
623 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
644 |
530 |
$0.00 |
| 90698 |
|
174 |
169 |
$0.00 |
| 90677 |
|
24 |
24 |
$0.00 |
| 0001F |
|
761 |
701 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
127 |
117 |
$0.00 |
| 90744 |
|
42 |
42 |
$0.00 |
| 3074F |
|
49 |
44 |
$0.00 |
| G8430 |
Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status) |
86 |
76 |
$0.00 |
| G8422 |
Bmi not documented, documentation the patient is not eligible for bmi calculation |
380 |
313 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
82 |
78 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
13 |
13 |
$0.00 |
| 87802 |
|
31 |
29 |
$0.00 |
| 3008F |
|
185 |
177 |
$0.00 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
13 |
13 |
$0.00 |
| 91307 |
|
13 |
12 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
13 |
13 |
$0.00 |