| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
81,382 |
70,010 |
$3.38M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
65,225 |
57,905 |
$1.54M |
| 99233 |
Prolong inpt eval add15 m |
18,049 |
5,709 |
$894K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
7,555 |
7,106 |
$366K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,687 |
5,396 |
$267K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
8,240 |
2,669 |
$252K |
| 99223 |
Prolong inpt eval add15 m |
2,678 |
2,437 |
$248K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,289 |
2,119 |
$218K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,913 |
3,657 |
$213K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,610 |
3,452 |
$166K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,212 |
1,178 |
$119K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
806 |
771 |
$118K |
| 71046 |
Radiologic examination, chest; 2 views |
4,221 |
3,902 |
$88K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,239 |
1,103 |
$66K |
| 31231 |
|
563 |
491 |
$62K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
265 |
252 |
$61K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
2,223 |
1,537 |
$56K |
| 99053 |
|
1,942 |
1,712 |
$51K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,207 |
1,159 |
$51K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,308 |
477 |
$45K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,983 |
4,679 |
$43K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
266 |
265 |
$41K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,111 |
1,081 |
$40K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
1,614 |
1,561 |
$40K |
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
2,391 |
2,264 |
$39K |
| 92557 |
|
1,460 |
1,328 |
$37K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,008 |
923 |
$35K |
| 20610 |
|
698 |
477 |
$31K |
| 17110 |
|
531 |
484 |
$23K |
| 92567 |
|
2,133 |
1,926 |
$20K |
| 99215 |
Prolong outpt/office vis |
384 |
333 |
$20K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,938 |
1,212 |
$17K |
| 11102 |
|
407 |
358 |
$16K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
636 |
564 |
$16K |
| 95024 |
|
231 |
219 |
$14K |
| 92551 |
|
15,062 |
14,001 |
$13K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
128 |
120 |
$11K |
| 0012A |
|
350 |
313 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,376 |
1,274 |
$10K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
54 |
24 |
$8K |
| 0011A |
|
327 |
294 |
$8K |
| 99051 |
|
439 |
396 |
$7K |
| 99243 |
|
66 |
64 |
$6K |
| 76536 |
|
95 |
82 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
599 |
561 |
$6K |
| 99173 |
|
15,210 |
14,177 |
$6K |
| 69210 |
|
254 |
189 |
$6K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
130 |
114 |
$5K |
| 73562 |
|
235 |
185 |
$5K |
| 94729 |
|
158 |
144 |
$5K |
| 94726 |
|
158 |
144 |
$5K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
58 |
45 |
$5K |
| 82947 |
|
1,819 |
1,533 |
$4K |
| 95117 |
|
305 |
91 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
560 |
500 |
$4K |
| 94010 |
|
212 |
191 |
$4K |
| 17000 |
|
185 |
166 |
$4K |
| 0013A |
|
125 |
121 |
$4K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
209 |
151 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,592 |
1,517 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
38 |
36 |
$3K |
| 81025 |
|
648 |
605 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
743 |
635 |
$3K |
| 93000 |
|
177 |
163 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
39 |
37 |
$2K |
| 72110 |
|
52 |
49 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
24 |
12 |
$2K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
72 |
26 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
44 |
38 |
$2K |
| 82962 |
|
933 |
827 |
$2K |
| 77080 |
|
29 |
29 |
$2K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
71 |
29 |
$2K |
| 73130 |
|
69 |
51 |
$2K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
461 |
395 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
55 |
53 |
$2K |
| 71250 |
|
15 |
13 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
48 |
38 |
$1K |
| 81002 |
|
645 |
606 |
$1K |
| 73110 |
|
54 |
48 |
$1K |
| 90686 |
|
125 |
118 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$1K |
| 99442 |
|
30 |
29 |
$1K |
| A4550 |
Surgical trays |
906 |
714 |
$1K |
| 99441 |
|
44 |
38 |
$1K |
| 73630 |
|
43 |
37 |
$1K |
| 97161 |
|
12 |
12 |
$820.22 |
| 99443 |
|
12 |
12 |
$622.76 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
72 |
64 |
$617.46 |
| 99381 |
|
14 |
14 |
$599.20 |
| 51798 |
|
47 |
43 |
$564.93 |
| V2020 |
Frames, purchases |
16 |
12 |
$505.33 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
38 |
$461.62 |
| 73610 |
|
17 |
15 |
$452.56 |
| 17003 |
|
27 |
24 |
$416.92 |
| 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) |
31 |
31 |
$383.61 |
| 99307 |
|
33 |
25 |
$382.28 |
| 97014 |
|
27 |
12 |
$334.70 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
21 |
12 |
$323.56 |
| 73030 |
|
15 |
12 |
$309.97 |
| 81003 |
|
179 |
161 |
$296.11 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
95 |
81 |
$264.12 |
| 92585 |
|
12 |
12 |
$232.34 |
| S9999 |
Sales tax |
2,201 |
1,763 |
$221.02 |
| 86580 |
|
63 |
59 |
$220.99 |
| 90662 |
|
27 |
26 |
$204.12 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
25 |
24 |
$177.80 |
| 1036F |
|
21,594 |
18,811 |
$130.10 |
| 92015 |
Determination of refractive state |
13 |
12 |
$126.61 |
| 85610 |
|
47 |
37 |
$125.98 |
| 1126F |
|
4,636 |
3,702 |
$91.41 |
| G0008 |
Administration of influenza virus vaccine |
28 |
27 |
$36.12 |
| 99177 |
|
12 |
12 |
$33.90 |
| A4215 |
Needle, sterile, any size, each |
12 |
12 |
$0.98 |
| 3074F |
|
61,168 |
50,686 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
20,864 |
17,308 |
$0.00 |
| 3075F |
|
2,085 |
1,662 |
$0.00 |
| 3079F |
|
5,724 |
4,906 |
$0.00 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
2,394 |
1,948 |
$0.00 |
| 1125F |
|
1,311 |
1,014 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
25 |
20 |
$0.00 |
| 91306 |
|
138 |
134 |
$0.00 |
| 91301 |
|
579 |
501 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
323 |
277 |
$0.00 |
| 1111F |
|
159 |
129 |
$0.00 |
| 3044F |
|
317 |
277 |
$0.00 |
| 1170F |
|
147 |
131 |
$0.00 |
| 7025F |
|
1,190 |
1,144 |
$0.00 |
| 4450F |
|
268 |
196 |
$0.00 |
| 91307 |
|
42 |
40 |
$0.00 |
| 1220F |
|
113 |
102 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
17 |
17 |
$0.00 |
| 3078F |
|
56,988 |
46,818 |
$0.00 |
| 1159F |
|
16,058 |
12,901 |
$0.00 |
| 3725F |
|
4,003 |
3,558 |
$0.00 |
| 1160F |
|
8,047 |
6,583 |
$0.00 |
| G9458 |
Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user |
65 |
55 |
$0.00 |
| 0521F |
|
2,899 |
2,482 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
1,889 |
1,689 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
25 |
20 |
$0.00 |
| 4004F |
|
83 |
67 |
$0.00 |
| 1158F |
|
219 |
195 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
28 |
20 |
$0.00 |
| 1124F |
|
34 |
25 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
57 |
47 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.00 |