| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52,666 |
50,191 |
$5.69M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25,311 |
24,645 |
$3.77M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,927 |
5,819 |
$855K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,903 |
1,855 |
$400K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,563 |
2,561 |
$348K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,576 |
2,463 |
$339K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,163 |
1,162 |
$242K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,722 |
1,720 |
$234K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,438 |
1,436 |
$199K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
2,250 |
665 |
$131K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,319 |
1,317 |
$128K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
758 |
758 |
$119K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
779 |
778 |
$117K |
| 99233 |
Prolong inpt eval add15 m |
1,101 |
369 |
$92K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,047 |
1,022 |
$90K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,172 |
1,150 |
$82K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
694 |
672 |
$74K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,441 |
3,417 |
$58K |
| 76830 |
Ultrasound, transvaginal |
686 |
683 |
$57K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,468 |
895 |
$44K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
237 |
237 |
$35K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,284 |
5,199 |
$31K |
| 90834 |
Psychotherapy, 45 minutes with patient |
526 |
391 |
$28K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
221 |
192 |
$23K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
133 |
133 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,974 |
1,968 |
$20K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
112 |
112 |
$19K |
| 93000 |
|
1,234 |
1,224 |
$16K |
| 20610 |
|
194 |
187 |
$15K |
| 95886 |
|
110 |
109 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,404 |
1,400 |
$13K |
| 92570 |
|
447 |
441 |
$11K |
| 99459 |
|
322 |
322 |
$10K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,438 |
1,412 |
$10K |
| 83655 |
|
725 |
725 |
$9K |
| 11721 |
|
276 |
276 |
$9K |
| 90686 |
|
1,923 |
1,922 |
$9K |
| 73564 |
|
238 |
236 |
$8K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
133 |
133 |
$7K |
| 51798 |
|
422 |
417 |
$6K |
| 92557 |
|
192 |
192 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
57 |
54 |
$6K |
| 81000 |
|
1,457 |
1,452 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
274 |
273 |
$5K |
| 72100 |
|
163 |
162 |
$5K |
| 81025 |
|
1,639 |
1,621 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
704 |
703 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
86 |
74 |
$3K |
| 81002 |
|
1,366 |
1,304 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
165 |
87 |
$2K |
| 99385 |
|
12 |
12 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
25 |
25 |
$2K |
| 92551 |
|
336 |
336 |
$2K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
12 |
12 |
$2K |
| 73630 |
|
64 |
59 |
$2K |
| 99441 |
|
25 |
24 |
$2K |
| 92567 |
|
172 |
170 |
$1K |
| 96127 |
|
214 |
214 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
14 |
13 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$1K |
| 92550 |
|
55 |
55 |
$1K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
90 |
90 |
$951.81 |
| 99442 |
|
12 |
12 |
$792.36 |
| 92568 |
|
61 |
61 |
$748.69 |
| 72040 |
|
26 |
26 |
$716.49 |
| 85018 |
|
327 |
327 |
$649.35 |
| 0072A |
|
16 |
16 |
$640.00 |
| 0071A |
|
12 |
12 |
$480.00 |
| 73610 |
|
14 |
14 |
$458.54 |
| 92587 |
|
12 |
12 |
$455.74 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
29 |
$455.02 |
| 73110 |
|
16 |
13 |
$397.91 |
| 95800 |
|
12 |
12 |
$312.96 |
| 73030 |
|
14 |
13 |
$277.79 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
52 |
50 |
$253.66 |
| 99406 |
|
12 |
12 |
$165.05 |
| 92504 |
|
27 |
25 |
$143.93 |
| 99051 |
|
13 |
13 |
$141.72 |
| 90619 |
|
68 |
68 |
$125.01 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
15 |
15 |
$118.50 |
| 99173 |
|
285 |
284 |
$93.58 |
| 81003 |
|
25 |
25 |
$39.50 |
| 90671 |
|
356 |
355 |
$0.16 |
| 90633 |
|
142 |
142 |
$0.00 |
| 90648 |
|
199 |
199 |
$0.00 |
| 90685 |
|
205 |
205 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
39 |
38 |
$0.00 |
| 90670 |
|
1,050 |
1,049 |
$0.00 |
| 90715 |
|
60 |
60 |
$0.00 |
| 90700 |
|
99 |
99 |
$0.00 |
| 90710 |
|
93 |
93 |
$0.00 |
| 90734 |
|
96 |
96 |
$0.00 |
| 90707 |
|
39 |
39 |
$0.00 |
| 90651 |
|
39 |
39 |
$0.00 |
| 90697 |
|
365 |
364 |
$0.00 |
| 90680 |
|
612 |
612 |
$0.00 |
| 90698 |
|
118 |
118 |
$0.00 |
| 90716 |
|
52 |
52 |
$0.00 |
| 90723 |
|
60 |
60 |
$0.00 |
| 90696 |
|
37 |
37 |
$0.00 |
| 90656 |
|
44 |
44 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |