| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,202 |
20,382 |
$2.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,569 |
9,398 |
$1.55M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,470 |
4,350 |
$892K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,081 |
4,120 |
$774K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,646 |
3,577 |
$676K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,354 |
2,308 |
$471K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,846 |
7,304 |
$330K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
8,549 |
7,824 |
$195K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
794 |
756 |
$129K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,609 |
11,082 |
$104K |
| 99215 |
Prolong outpt/office vis |
380 |
364 |
$82K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
549 |
524 |
$58K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
6,544 |
5,688 |
$40K |
| 92552 |
|
4,896 |
4,796 |
$34K |
| 17250 |
|
498 |
312 |
$26K |
| 90461 |
|
3,204 |
3,070 |
$25K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,597 |
3,255 |
$21K |
| 86580 |
|
8,481 |
8,280 |
$19K |
| 92550 |
|
2,595 |
2,037 |
$16K |
| 99051 |
|
3,826 |
3,514 |
$15K |
| 99188 |
|
3,322 |
3,206 |
$13K |
| 92587 |
|
2,962 |
2,842 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
92 |
74 |
$12K |
| 99401 |
|
476 |
454 |
$11K |
| 94010 |
|
768 |
690 |
$10K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,020 |
1,825 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,489 |
2,350 |
$10K |
| 99205 |
Prolong outpt/office vis |
47 |
39 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,780 |
1,494 |
$7K |
| 93000 |
|
1,907 |
1,834 |
$7K |
| 81003 |
|
4,638 |
4,415 |
$6K |
| 86769 |
|
350 |
331 |
$6K |
| 83655 |
|
2,207 |
2,131 |
$5K |
| 85027 |
|
2,024 |
1,926 |
$4K |
| 97802 |
|
4,845 |
4,448 |
$4K |
| 90686 |
|
3,768 |
3,643 |
$3K |
| 90680 |
|
1,867 |
1,787 |
$3K |
| 94060 |
|
288 |
261 |
$3K |
| 99173 |
|
4,935 |
4,626 |
$3K |
| 94667 |
|
1,264 |
1,110 |
$3K |
| 82947 |
|
1,271 |
1,214 |
$2K |
| 96160 |
|
4,563 |
4,064 |
$2K |
| S9451 |
Exercise classes, non-physician provider, per session |
5,483 |
4,818 |
$2K |
| 99490 |
Ccm add 20min |
34 |
34 |
$2K |
| 85018 |
|
1,978 |
1,866 |
$2K |
| 94664 |
|
1,383 |
1,215 |
$2K |
| 96127 |
|
1,570 |
1,377 |
$2K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,143 |
962 |
$2K |
| 36416 |
|
4,286 |
3,691 |
$1K |
| 96161 |
|
1,568 |
1,463 |
$1K |
| 99354 |
|
426 |
376 |
$1K |
| 90670 |
|
2,241 |
2,147 |
$701.62 |
| 99442 |
|
31 |
30 |
$649.83 |
| 82948 |
|
443 |
389 |
$638.21 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
331 |
304 |
$634.26 |
| 99174 |
|
1,122 |
997 |
$605.46 |
| 96380 |
|
49 |
46 |
$575.48 |
| 90700 |
|
348 |
299 |
$568.63 |
| G9920 |
Screening performed and negative |
696 |
560 |
$540.02 |
| S9441 |
Asthma education, non-physician provider, per session |
261 |
243 |
$503.31 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
223 |
207 |
$480.20 |
| 82247 |
|
261 |
160 |
$453.02 |
| 81002 |
|
158 |
152 |
$439.15 |
| 90647 |
|
770 |
751 |
$361.43 |
| H0049 |
Alcohol and/or drug screening |
14 |
14 |
$295.47 |
| 90656 |
|
171 |
162 |
$278.00 |
| 90633 |
|
1,225 |
1,162 |
$231.06 |
| 87807 |
|
174 |
165 |
$227.60 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
382 |
334 |
$184.68 |
| 90648 |
|
174 |
136 |
$175.55 |
| 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) |
16 |
13 |
$165.78 |
| 90744 |
|
487 |
447 |
$160.04 |
| 90716 |
|
873 |
841 |
$159.04 |
| 90651 |
|
569 |
556 |
$159.01 |
| 0071A |
|
34 |
32 |
$140.00 |
| 90698 |
|
1,029 |
998 |
$91.01 |
| 99000 |
|
94 |
91 |
$88.68 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
407 |
388 |
$86.60 |
| 0072A |
|
16 |
14 |
$65.00 |
| 99355 |
|
40 |
31 |
$58.77 |
| 90685 |
|
27 |
16 |
$48.02 |
| A7015 |
Aerosol mask, used with dme nebulizer |
32 |
29 |
$32.22 |
| 94760 |
|
334 |
263 |
$26.73 |
| 90734 |
|
32 |
32 |
$24.01 |
| 90707 |
|
803 |
757 |
$18.87 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
102 |
93 |
$1.58 |
| 91307 |
|
64 |
43 |
$0.10 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
133 |
122 |
$0.09 |
| 90713 |
|
69 |
43 |
$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 |
260 |
252 |
$0.00 |
| 99177 |
|
174 |
162 |
$0.00 |
| 90671 |
|
22 |
21 |
$0.00 |
| 0002A |
|
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
40 |
$0.00 |
| 81025 |
|
44 |
42 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 92015 |
Determination of refractive state |
32 |
26 |
$0.00 |
| 99406 |
|
125 |
120 |
$0.00 |
| 90723 |
|
236 |
232 |
$0.00 |
| 90696 |
|
29 |
28 |
$0.00 |
| 90634 |
|
58 |
55 |
$0.00 |
| 90677 |
|
113 |
111 |
$0.00 |
| 99417 |
Prolong home eval add 15m |
156 |
126 |
$0.00 |
| 90620 |
|
41 |
41 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
44 |
31 |
$0.00 |
| 99050 |
|
12 |
12 |
$0.00 |
| 81001 |
|
24 |
21 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$0.00 |
| 90688 |
|
21 |
18 |
$0.00 |