| Code | Description | Claims | Beneficiaries | Total Paid |
| H1000 |
Prenatal care, at-risk assessment |
61,946 |
39,504 |
$3.10M |
| 99233 |
Prolong inpt eval add15 m |
70,284 |
27,787 |
$2.55M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65,068 |
52,202 |
$2.43M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
81,120 |
30,970 |
$1.87M |
| 59410 |
|
1,753 |
1,581 |
$1.84M |
| 99223 |
Prolong inpt eval add15 m |
23,093 |
18,228 |
$1.78M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,668 |
31,367 |
$1.29M |
| 99239 |
Hospital discharge day management, more than 30 minutes |
20,006 |
15,906 |
$907K |
| 59515 |
|
817 |
719 |
$844K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,970 |
4,180 |
$422K |
| 99220 |
|
4,056 |
3,124 |
$306K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,789 |
4,051 |
$300K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
3,058 |
2,670 |
$276K |
| 59430 |
|
2,230 |
1,926 |
$260K |
| 76801 |
|
1,679 |
1,439 |
$236K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,610 |
2,753 |
$215K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,287 |
1,809 |
$215K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,870 |
2,367 |
$208K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,930 |
1,709 |
$207K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,031 |
1,735 |
$200K |
| 59025 |
Fetal non-stress test |
4,948 |
2,962 |
$195K |
| 76818 |
|
1,521 |
972 |
$166K |
| 99222 |
Initial hospital care, per day, moderate complexity |
2,720 |
2,199 |
$146K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,603 |
4,570 |
$142K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,861 |
1,641 |
$137K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
871 |
289 |
$79K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,439 |
1,105 |
$77K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,379 |
1,132 |
$71K |
| 99385 |
|
1,066 |
824 |
$69K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,786 |
4,982 |
$68K |
| 99215 |
Prolong outpt/office vis |
1,383 |
1,201 |
$64K |
| 81025 |
|
24,994 |
20,297 |
$60K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,341 |
2,807 |
$56K |
| 99217 |
|
1,909 |
1,565 |
$54K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
871 |
577 |
$51K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
790 |
609 |
$49K |
| 99205 |
Prolong outpt/office vis |
435 |
357 |
$45K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
29 |
27 |
$44K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,145 |
543 |
$41K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
457 |
397 |
$39K |
| 95720 |
|
331 |
159 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
307 |
240 |
$28K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
652 |
552 |
$27K |
| 76830 |
Ultrasound, transvaginal |
319 |
285 |
$26K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
741 |
560 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,219 |
830 |
$21K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
224 |
212 |
$19K |
| 93000 |
|
4,911 |
3,845 |
$17K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
183 |
136 |
$16K |
| 20610 |
|
505 |
373 |
$13K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
306 |
246 |
$12K |
| 99236 |
Prolong inpt eval add15 m |
108 |
95 |
$12K |
| 58670 |
|
50 |
42 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,218 |
1,776 |
$11K |
| 92552 |
|
1,220 |
930 |
$10K |
| 99221 |
|
174 |
132 |
$8K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
60 |
57 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
576 |
451 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
93 |
47 |
$6K |
| 90461 |
|
333 |
299 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,756 |
3,352 |
$5K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
43 |
41 |
$5K |
| 95117 |
|
751 |
312 |
$5K |
| 93015 |
|
172 |
136 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
5,480 |
4,218 |
$5K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
23 |
14 |
$5K |
| 85018 |
|
5,231 |
4,633 |
$4K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
53 |
41 |
$4K |
| 99243 |
|
42 |
40 |
$4K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
813 |
594 |
$4K |
| 81003 |
|
4,635 |
3,773 |
$3K |
| 99253 |
|
78 |
52 |
$3K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
37 |
26 |
$3K |
| 99407 |
|
552 |
379 |
$3K |
| 99254 |
|
36 |
27 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
196 |
168 |
$3K |
| 76820 |
|
158 |
80 |
$3K |
| 99255 |
|
49 |
39 |
$2K |
| 81002 |
|
3,512 |
2,670 |
$2K |
| 99219 |
|
46 |
39 |
$2K |
| 87428 |
|
215 |
139 |
$2K |
| 94690 |
|
76 |
66 |
$2K |
| 99245 |
|
12 |
12 |
$2K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
140 |
58 |
$2K |
| 99252 |
|
37 |
36 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
29 |
26 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
469 |
415 |
$1K |
| 3074F |
|
86,967 |
63,834 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
567 |
503 |
$1K |
| 99406 |
|
620 |
448 |
$1K |
| 58301 |
|
12 |
12 |
$953.21 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
322 |
270 |
$879.85 |
| 82962 |
|
546 |
477 |
$691.62 |
| 97803 |
|
20 |
18 |
$667.58 |
| 43250 |
|
14 |
13 |
$640.12 |
| 76857 |
|
12 |
12 |
$620.60 |
| 1036F |
|
28,805 |
23,718 |
$585.65 |
| 90686 |
|
164 |
129 |
$579.34 |
| 97597 |
|
18 |
12 |
$575.87 |
| 36416 |
|
5,612 |
4,619 |
$563.50 |
| 87806 |
|
154 |
127 |
$562.05 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
85 |
64 |
$522.01 |
| 90473 |
|
59 |
57 |
$480.20 |
| 99442 |
|
34 |
23 |
$431.42 |
| 51798 |
|
151 |
119 |
$367.45 |
| 52000 |
|
15 |
13 |
$357.38 |
| 93297 |
|
38 |
26 |
$348.04 |
| 95816 |
|
18 |
14 |
$317.53 |
| 90680 |
|
439 |
344 |
$270.02 |
| 90710 |
|
122 |
102 |
$265.02 |
| 82950 |
|
312 |
294 |
$262.33 |
| 90670 |
|
828 |
655 |
$239.04 |
| 93244 |
|
13 |
12 |
$204.18 |
| 87807 |
|
26 |
24 |
$202.11 |
| 96373 |
|
16 |
13 |
$195.87 |
| 73130 |
|
12 |
12 |
$165.28 |
| 90744 |
|
149 |
111 |
$123.01 |
| 99441 |
|
13 |
13 |
$108.65 |
| 0503F |
|
1,439 |
1,195 |
$107.31 |
| 99401 |
|
22 |
17 |
$82.93 |
| 90633 |
|
163 |
139 |
$79.02 |
| 99422 |
|
29 |
15 |
$57.27 |
| 3075F |
|
4,064 |
3,419 |
$52.00 |
| 3077F |
|
2,012 |
1,580 |
$52.00 |
| 93242 |
|
27 |
24 |
$50.32 |
| 90688 |
|
42 |
35 |
$33.00 |
| 96127 |
|
175 |
122 |
$23.21 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16 |
13 |
$20.47 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
17 |
12 |
$14.96 |
| 87210 |
|
12 |
12 |
$4.54 |
| 81000 |
|
32 |
16 |
$4.25 |
| 81001 |
|
15 |
12 |
$3.11 |
| 1126F |
|
3,441 |
3,080 |
$0.00 |
| 3079F |
|
19,434 |
15,122 |
$0.00 |
| 3080F |
|
1,281 |
1,018 |
$0.00 |
| 1101F |
|
92 |
84 |
$0.00 |
| 99000 |
|
199 |
173 |
$0.00 |
| 1125F |
|
1,968 |
1,687 |
$0.00 |
| 90698 |
|
344 |
246 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
514 |
432 |
$0.00 |
| 90743 |
|
37 |
27 |
$0.00 |
| 92551 |
|
106 |
85 |
$0.00 |
| 3008F |
|
496 |
377 |
$0.00 |
| 90723 |
|
76 |
64 |
$0.00 |
| 90647 |
|
216 |
180 |
$0.00 |
| 0500F |
|
12 |
12 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
17 |
12 |
$0.00 |
| 3078F |
|
72,303 |
52,041 |
$0.00 |
| 3725F |
|
6,546 |
5,199 |
$0.00 |
| 0502F |
|
98 |
76 |
$0.00 |
| 99173 |
|
1,043 |
773 |
$0.00 |
| 99177 |
|
37 |
36 |
$0.00 |
| 3288F |
|
253 |
219 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
13 |
13 |
$0.00 |
| 99418 |
Prolong nursin fac eval 15m |
33 |
12 |
$0.00 |