| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,748 |
18,653 |
$1.13M |
| 99215 |
Prolong outpt/office vis |
6,976 |
5,865 |
$479K |
| 99000 |
|
47,021 |
18,054 |
$469K |
| 95012 |
|
21,573 |
13,151 |
$397K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30,855 |
12,687 |
$376K |
| 94010 |
|
16,491 |
13,189 |
$345K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,093 |
2,895 |
$249K |
| 92081 |
|
10,195 |
9,346 |
$231K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,924 |
4,893 |
$210K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,444 |
2,284 |
$205K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,643 |
2,434 |
$197K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,410 |
1,240 |
$193K |
| 96112 |
|
2,015 |
1,870 |
$180K |
| 36410 |
|
18,179 |
7,937 |
$147K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,737 |
1,564 |
$124K |
| 96130 |
|
2,310 |
2,054 |
$121K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,522 |
4,751 |
$102K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
8,437 |
7,062 |
$93K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,212 |
2,000 |
$91K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
7,681 |
6,662 |
$89K |
| 92552 |
|
8,629 |
7,990 |
$78K |
| 80061 |
Lipid panel |
7,455 |
6,809 |
$63K |
| 83655 |
|
6,962 |
6,389 |
$61K |
| 95076 |
|
1,336 |
1,183 |
$51K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
684 |
651 |
$47K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
625 |
594 |
$47K |
| 36406 |
|
6,020 |
2,113 |
$46K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,133 |
6,516 |
$46K |
| 99354 |
|
1,289 |
1,035 |
$45K |
| S9470 |
Nutritional counseling, dietitian visit |
1,087 |
1,012 |
$45K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,395 |
3,499 |
$44K |
| 90837 |
Psychotherapy, 53 minutes with patient |
385 |
292 |
$44K |
| 99205 |
Prolong outpt/office vis |
428 |
397 |
$40K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
6,480 |
5,981 |
$38K |
| 99050 |
|
2,710 |
2,435 |
$36K |
| 90834 |
Psychotherapy, 45 minutes with patient |
447 |
344 |
$32K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,984 |
1,785 |
$30K |
| 98960 |
|
21,186 |
16,924 |
$29K |
| 99417 |
Prolong home eval add 15m |
3,022 |
2,579 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,180 |
1,093 |
$26K |
| 90461 |
|
8,578 |
2,275 |
$18K |
| 87430 |
|
1,486 |
1,356 |
$18K |
| 99441 |
|
877 |
722 |
$17K |
| 90832 |
Psychotherapy, 30 minutes with patient |
229 |
168 |
$11K |
| 81002 |
|
4,017 |
3,578 |
$10K |
| 87807 |
|
1,055 |
930 |
$9K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
208 |
190 |
$9K |
| 80502 |
|
887 |
800 |
$8K |
| 96156 |
|
948 |
877 |
$8K |
| 99381 |
|
125 |
105 |
$8K |
| 97802 |
|
10,008 |
8,919 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
522 |
502 |
$6K |
| 99442 |
|
230 |
207 |
$6K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
486 |
448 |
$6K |
| 90899 |
|
157 |
146 |
$6K |
| 90688 |
|
1,622 |
1,549 |
$5K |
| 96158 |
|
914 |
849 |
$5K |
| 96111 |
|
53 |
49 |
$5K |
| 90677 |
|
276 |
256 |
$4K |
| 99078 |
|
779 |
625 |
$4K |
| 85027 |
|
874 |
791 |
$4K |
| 96131 |
|
73 |
66 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
439 |
395 |
$3K |
| 86580 |
|
479 |
453 |
$3K |
| 80503 |
|
337 |
314 |
$3K |
| 80053 |
Comprehensive metabolic panel |
443 |
400 |
$3K |
| 96160 |
|
22,913 |
18,546 |
$3K |
| 99384 |
|
24 |
24 |
$2K |
| 99358 |
Prolong nursin fac eval 15m |
285 |
239 |
$2K |
| 99355 |
|
114 |
98 |
$2K |
| 90651 |
|
249 |
238 |
$2K |
| 0001A |
|
57 |
55 |
$2K |
| A9150 |
Non-prescription drugs |
1,766 |
1,542 |
$2K |
| 90670 |
|
968 |
924 |
$2K |
| 99382 |
|
26 |
25 |
$2K |
| 99402 |
|
1,940 |
1,818 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$2K |
| 99383 |
|
19 |
19 |
$2K |
| 93000 |
|
131 |
121 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
133 |
113 |
$1K |
| 90734 |
|
445 |
435 |
$1K |
| 94760 |
|
11,332 |
9,402 |
$1K |
| 85014 |
|
762 |
712 |
$1K |
| 99429 |
|
184 |
171 |
$1K |
| 0002A |
|
30 |
30 |
$1K |
| 99404 |
|
370 |
348 |
$997.50 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
251 |
239 |
$964.25 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,740 |
1,567 |
$787.68 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
16 |
15 |
$752.24 |
| 96161 |
|
7,554 |
6,333 |
$720.21 |
| 87802 |
|
70 |
70 |
$662.78 |
| 82607 |
|
79 |
76 |
$646.17 |
| 84439 |
|
137 |
131 |
$636.34 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
614 |
530 |
$614.26 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$612.64 |
| 82746 |
|
76 |
73 |
$605.15 |
| 82950 |
|
173 |
146 |
$582.54 |
| 69210 |
|
17 |
13 |
$581.45 |
| 96136 |
|
18 |
16 |
$574.60 |
| 99499 |
|
139 |
135 |
$480.06 |
| 90733 |
|
60 |
54 |
$404.46 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
67 |
60 |
$383.54 |
| 87420 |
|
241 |
188 |
$373.76 |
| 90633 |
|
556 |
529 |
$354.38 |
| 15852 |
|
15 |
14 |
$336.76 |
| 36400 |
|
18 |
17 |
$326.25 |
| 82465 |
|
85 |
84 |
$293.39 |
| 90671 |
|
15 |
15 |
$231.94 |
| 81000 |
|
216 |
177 |
$224.83 |
| 90715 |
|
180 |
175 |
$196.87 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
67 |
60 |
$175.24 |
| 97803 |
|
649 |
592 |
$175.05 |
| 81025 |
|
27 |
27 |
$173.52 |
| 86318 |
|
15 |
15 |
$144.72 |
| 85018 |
|
338 |
316 |
$140.62 |
| 99051 |
|
4,162 |
3,612 |
$124.55 |
| 99483 |
Prolong outpt/office vis |
422 |
399 |
$100.00 |
| 99484 |
|
406 |
395 |
$35.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
140 |
133 |
$21.90 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,973 |
1,636 |
$15.03 |
| 92551 |
|
14 |
14 |
$9.82 |
| 92283 |
|
7,446 |
6,922 |
$8.74 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
7,004 |
5,908 |
$7.72 |
| 96127 |
|
18,028 |
14,883 |
$7.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
56 |
54 |
$2.53 |
| J7614 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
14 |
13 |
$0.72 |
| 3078F |
|
1,525 |
1,414 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
12,186 |
10,136 |
$0.00 |
| S9449 |
Weight management classes, non-physician provider, per session |
1,915 |
1,597 |
$0.00 |
| 99401 |
|
727 |
683 |
$0.00 |
| 90648 |
|
25 |
24 |
$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 |
303 |
277 |
$0.00 |
| G9923 |
Safety concerns screen provided and negative |
632 |
588 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
480 |
426 |
$0.00 |
| 6102F |
|
864 |
792 |
$0.00 |
| 90785 |
|
1,219 |
1,070 |
$0.00 |
| 90710 |
|
374 |
368 |
$0.00 |
| 3725F |
|
5,749 |
4,819 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,409 |
1,207 |
$0.00 |
| 90700 |
|
96 |
90 |
$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 |
2,703 |
2,304 |
$0.00 |
| 4004F |
|
12 |
12 |
$0.00 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
345 |
319 |
$0.00 |
| 99173 |
|
515 |
494 |
$0.00 |
| 90863 |
|
2,468 |
2,107 |
$0.00 |
| 91300 |
|
186 |
169 |
$0.00 |
| 4551F |
|
4,537 |
3,905 |
$0.00 |
| D0190 |
|
851 |
799 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
161 |
153 |
$0.00 |
| 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) |
636 |
540 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
503 |
469 |
$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 |
294 |
284 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
181 |
158 |
$0.00 |
| G8421 |
Bmi not documented and no reason is given |
62 |
59 |
$0.00 |
| G8476 |
Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg |
85 |
82 |
$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 |
262 |
260 |
$0.00 |
| 99411 |
|
42 |
32 |
$0.00 |
| 99080 |
|
20 |
17 |
$0.00 |
| 99359 |
Prolong nursin fac eval 15m |
15 |
12 |
$0.00 |
| H0022 |
Alcohol and/or drug intervention service (planned facilitation) |
27 |
24 |
$0.00 |
| 90680 |
|
576 |
549 |
$0.00 |
| 2001F |
|
974 |
862 |
$0.00 |
| 90697 |
|
313 |
295 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
1,090 |
991 |
$0.00 |
| 99403 |
|
54 |
48 |
$0.00 |
| 82962 |
|
614 |
491 |
$0.00 |
| 4060F |
|
1,121 |
1,014 |
$0.00 |
| 90696 |
|
124 |
120 |
$0.00 |
| 3048F |
|
107 |
101 |
$0.00 |
| 3700F |
|
1,137 |
1,033 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
952 |
858 |
$0.00 |
| 2000F |
|
124 |
90 |
$0.00 |
| 0001F |
|
1,598 |
1,468 |
$0.00 |
| 2016F |
|
104 |
94 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
724 |
649 |
$0.00 |
| 90723 |
|
331 |
310 |
$0.00 |
| 3008F |
|
183 |
163 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
488 |
435 |
$0.00 |
| 90647 |
|
512 |
495 |
$0.00 |
| 3074F |
|
526 |
494 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
1,801 |
1,617 |
$0.00 |
| 1111F |
|
10,370 |
8,621 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
346 |
318 |
$0.00 |
| 99489 |
Ccm add 20min |
77 |
71 |
$0.00 |
| G8422 |
Bmi not documented, documentation the patient is not eligible for bmi calculation |
715 |
608 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
15 |
$0.00 |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
16 |
15 |
$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) |
314 |
283 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
1,667 |
1,517 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
219 |
197 |
$0.00 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
166 |
152 |
$0.00 |
| 3292F |
|
16 |
13 |
$0.00 |
| 2015F |
|
85 |
74 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
94 |
86 |
$0.00 |
| 1005F |
|
125 |
110 |
$0.00 |
| 87084 |
|
56 |
45 |
$0.00 |
| 87071 |
|
20 |
15 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
163 |
136 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
18 |
16 |
$0.00 |
| 3044F |
|
103 |
97 |
$0.00 |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
14 |
13 |
$0.00 |
| 87073 |
|
20 |
15 |
$0.00 |
| 90698 |
|
30 |
29 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
33 |
32 |
$0.00 |
| 97804 |
|
61 |
55 |
$0.00 |
| 87070 |
|
20 |
15 |
$0.00 |
| 3011F |
|
14 |
13 |
$0.00 |