| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38,984 |
35,722 |
$2.87M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,691 |
47,613 |
$2.67M |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
27,603 |
27,052 |
$806K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,161 |
7,930 |
$548K |
| X5622 |
|
11,313 |
10,193 |
$522K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16,474 |
16,154 |
$447K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
12,381 |
12,057 |
$429K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,926 |
6,459 |
$404K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,228 |
5,892 |
$398K |
| 99215 |
Prolong outpt/office vis |
3,157 |
2,978 |
$307K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,741 |
3,633 |
$260K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,896 |
2,726 |
$197K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,738 |
1,707 |
$192K |
| 36415 |
Collection of venous blood by venipuncture |
48,737 |
44,204 |
$186K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12,163 |
11,912 |
$166K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,867 |
1,793 |
$131K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,494 |
1,429 |
$120K |
| 99188 |
|
12,802 |
12,610 |
$108K |
| 76830 |
Ultrasound, transvaginal |
1,388 |
1,351 |
$108K |
| 92551 |
|
16,824 |
16,483 |
$103K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,282 |
1,250 |
$93K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,056 |
1,048 |
$89K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,261 |
1,150 |
$88K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,178 |
1,163 |
$87K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,450 |
2,331 |
$74K |
| 96127 |
|
19,868 |
19,543 |
$72K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,690 |
1,654 |
$71K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
11,051 |
9,671 |
$69K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,265 |
3,078 |
$54K |
| 90686 |
|
10,504 |
10,416 |
$54K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
882 |
418 |
$52K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,595 |
6,261 |
$50K |
| 87480 |
|
2,503 |
2,407 |
$50K |
| 87660 |
|
2,496 |
2,401 |
$50K |
| 87510 |
|
2,495 |
2,402 |
$50K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
303 |
290 |
$45K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
508 |
498 |
$43K |
| 71046 |
Radiologic examination, chest; 2 views |
2,301 |
2,187 |
$42K |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
1,124 |
1,077 |
$39K |
| 0001A |
|
809 |
806 |
$36K |
| 90715 |
|
2,309 |
2,268 |
$35K |
| 90651 |
|
1,825 |
1,789 |
$32K |
| 85027 |
|
4,696 |
4,608 |
$31K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,909 |
1,886 |
$29K |
| 0002A |
|
594 |
593 |
$26K |
| 91320 |
|
209 |
209 |
$25K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
97 |
93 |
$24K |
| 99385 |
|
250 |
246 |
$23K |
| 99173 |
|
16,061 |
15,846 |
$23K |
| 0071A |
|
566 |
530 |
$22K |
| 17110 |
|
316 |
283 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,315 |
2,049 |
$22K |
| 0004A |
|
558 |
502 |
$21K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
206 |
205 |
$18K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
117 |
117 |
$17K |
| 0072A |
|
420 |
404 |
$17K |
| 81025 |
|
2,217 |
2,153 |
$17K |
| 76801 |
|
177 |
174 |
$17K |
| 99384 |
|
172 |
167 |
$15K |
| 80050 |
General health panel |
266 |
264 |
$15K |
| 99383 |
|
166 |
164 |
$13K |
| 90480 |
|
387 |
360 |
$13K |
| 90670 |
|
4,132 |
4,079 |
$12K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
296 |
296 |
$12K |
| 90677 |
|
160 |
155 |
$12K |
| 81001 |
|
3,705 |
3,496 |
$10K |
| 85018 |
|
4,123 |
4,050 |
$10K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
74 |
69 |
$9K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
135 |
117 |
$9K |
| 93000 |
|
930 |
908 |
$9K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
344 |
320 |
$9K |
| 90461 |
|
1,832 |
1,723 |
$8K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
263 |
223 |
$7K |
| 73630 |
|
342 |
308 |
$7K |
| 0124A |
|
166 |
163 |
$6K |
| 99460 |
|
152 |
141 |
$6K |
| 36416 |
|
2,720 |
2,584 |
$6K |
| 90746 |
|
141 |
138 |
$6K |
| 90674 |
|
811 |
798 |
$6K |
| 0054A |
|
129 |
124 |
$5K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
137 |
129 |
$5K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
2,183 |
2,079 |
$5K |
| 96161 |
|
3,136 |
3,026 |
$5K |
| 81003 |
|
2,453 |
2,393 |
$5K |
| 76813 |
|
54 |
54 |
$5K |
| 0064A |
|
102 |
102 |
$4K |
| 90716 |
|
993 |
984 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
383 |
377 |
$4K |
| 90750 |
|
30 |
30 |
$4K |
| 85049 |
|
822 |
785 |
$4K |
| 95117 |
|
518 |
208 |
$4K |
| 88142 |
|
525 |
519 |
$4K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
27 |
27 |
$4K |
| G0008 |
Administration of influenza virus vaccine |
215 |
213 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
109 |
105 |
$3K |
| 90732 |
|
61 |
61 |
$3K |
| 90661 |
|
562 |
561 |
$3K |
| 90734 |
|
1,704 |
1,653 |
$3K |
| G0179 |
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
109 |
106 |
$3K |
| 0051A |
|
71 |
69 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,215 |
1,127 |
$3K |
| 86780 |
|
571 |
561 |
$3K |
| 99381 |
|
28 |
28 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
735 |
690 |
$2K |
| 90694 |
|
131 |
131 |
$2K |
| 90707 |
|
846 |
840 |
$2K |
| 74019 |
|
142 |
128 |
$2K |
| 96160 |
|
858 |
844 |
$2K |
| 99386 |
|
14 |
14 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
26 |
24 |
$2K |
| 0012A |
|
34 |
34 |
$2K |
| 85610 |
|
463 |
315 |
$1K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
27 |
25 |
$1K |
| 87088 |
|
337 |
321 |
$1K |
| 76536 |
|
14 |
14 |
$1K |
| 0134A |
|
28 |
28 |
$1K |
| 90473 |
|
92 |
92 |
$1K |
| 0011A |
|
24 |
24 |
$1K |
| G0659 |
Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes |
56 |
52 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,248 |
1,194 |
$1K |
| 86480 |
|
74 |
71 |
$924.24 |
| 87077 |
|
305 |
257 |
$903.08 |
| 87070 |
|
247 |
236 |
$781.83 |
| 72100 |
|
26 |
26 |
$761.54 |
| 94010 |
|
55 |
53 |
$760.49 |
| 58300 |
|
12 |
12 |
$726.36 |
| 73610 |
|
29 |
26 |
$667.96 |
| 87186 |
|
211 |
187 |
$659.56 |
| 90672 |
|
753 |
745 |
$646.00 |
| 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) |
484 |
470 |
$623.87 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,609 |
1,182 |
$603.69 |
| 86762 |
|
85 |
85 |
$572.40 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
12 |
12 |
$570.33 |
| 90662 |
|
72 |
70 |
$528.06 |
| 0052A |
|
12 |
12 |
$525.22 |
| 0154A |
|
12 |
12 |
$492.44 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
20 |
13 |
$490.46 |
| 86850 |
|
97 |
96 |
$454.52 |
| 73140 |
|
26 |
25 |
$415.69 |
| 90474 |
|
37 |
37 |
$387.56 |
| 99153 |
Mod sedat endo service >5yrs |
94 |
82 |
$272.93 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$232.83 |
| 90710 |
|
702 |
694 |
$194.58 |
| 96381 |
|
13 |
12 |
$188.62 |
| 90633 |
|
2,432 |
2,402 |
$144.98 |
| 86900 |
|
58 |
58 |
$114.03 |
| 86901 |
|
57 |
57 |
$109.90 |
| 90680 |
|
2,231 |
2,202 |
$68.99 |
| 80051 |
|
13 |
12 |
$61.52 |
| 90723 |
|
2,912 |
2,878 |
$56.05 |
| 90647 |
|
2,882 |
2,852 |
$48.50 |
| 82565 |
|
13 |
12 |
$45.21 |
| 90696 |
|
783 |
772 |
$39.48 |
| 99441 |
|
56 |
56 |
$38.63 |
| 99443 |
|
20 |
20 |
$27.23 |
| 99442 |
|
85 |
85 |
$23.29 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15 |
15 |
$19.67 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
12 |
$13.52 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
28 |
24 |
$0.78 |
| 87205 |
|
12 |
12 |
$0.00 |
| 91319 |
|
12 |
12 |
$0.00 |
| 82962 |
|
50 |
46 |
$0.00 |
| 87081 |
|
608 |
556 |
$0.00 |
| 90660 |
|
14 |
14 |
$0.00 |
| 90700 |
|
783 |
775 |
$0.00 |
| 87210 |
|
121 |
109 |
$0.00 |
| 74018 |
|
12 |
12 |
$0.00 |
| 86618 |
|
15 |
14 |
$0.00 |
| 90685 |
|
178 |
166 |
$0.00 |
| 90713 |
|
16 |
15 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
22 |
12 |
$0.00 |