| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,045 |
1,942 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,587 |
16,534 |
$31K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
87 |
56 |
$21K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
685 |
192 |
$20K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,250 |
3,194 |
$17K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,228 |
3,171 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
194 |
194 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
336 |
322 |
$11K |
| 92134 |
|
67 |
50 |
$10K |
| 99199 |
Unlisted special service, procedure or report |
1,131 |
995 |
$10K |
| J3490 |
Unclassified drugs |
373 |
296 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
834 |
808 |
$7K |
| 59425 |
|
2,670 |
1,844 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,373 |
1,290 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
263 |
252 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
99 |
$5K |
| 81025 |
|
1,187 |
1,145 |
$4K |
| 80053 |
Comprehensive metabolic panel |
5,731 |
5,454 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
168 |
162 |
$4K |
| J1815 |
Injection, insulin, per 5 units |
17 |
15 |
$4K |
| 0515 |
|
331 |
322 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,073 |
5,421 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
300 |
290 |
$3K |
| 93000 |
|
154 |
146 |
$3K |
| 90670 |
|
519 |
484 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
24 |
24 |
$2K |
| S5571 |
Insulin delivery device, disposable pen (including insulin); 3 ml size |
28 |
27 |
$2K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
320 |
307 |
$2K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
664 |
626 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,800 |
6,326 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
73 |
54 |
$2K |
| 90686 |
|
708 |
708 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
7,258 |
6,887 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
38 |
38 |
$1K |
| 85018 |
|
1,030 |
996 |
$1K |
| 92081 |
|
731 |
699 |
$1K |
| 92552 |
|
1,388 |
1,362 |
$1K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
92 |
91 |
$1K |
| 92015 |
Determination of refractive state |
146 |
146 |
$1K |
| 0949 |
|
264 |
241 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,755 |
3,719 |
$1K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
519 |
516 |
$1K |
| 0450 |
Emergency room services |
262 |
255 |
$965.40 |
| 94760 |
|
491 |
469 |
$952.45 |
| A4267 |
Contraceptive supply, condom, male, each |
78 |
76 |
$937.78 |
| 99000 |
|
5,666 |
5,154 |
$916.26 |
| 92250 |
|
27 |
25 |
$910.22 |
| 90734 |
|
228 |
218 |
$901.98 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$895.02 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
38 |
38 |
$883.89 |
| V2020 |
Frames, purchases |
41 |
41 |
$873.71 |
| 3074F |
|
155 |
144 |
$847.91 |
| 81002 |
|
2,138 |
1,544 |
$833.46 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,814 |
3,792 |
$819.18 |
| 81001 |
|
1,629 |
1,552 |
$787.27 |
| 3008F |
|
295 |
259 |
$748.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
764 |
573 |
$706.46 |
| 90707 |
|
218 |
218 |
$692.03 |
| 85027 |
|
684 |
524 |
$668.92 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
451 |
449 |
$628.78 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
410 |
387 |
$620.54 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
118 |
107 |
$607.37 |
| 80061 |
Lipid panel |
4,369 |
4,336 |
$594.56 |
| 99401 |
|
385 |
382 |
$594.49 |
| 90700 |
|
367 |
335 |
$536.93 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,834 |
1,824 |
$532.06 |
| 86592 |
|
2,318 |
2,301 |
$493.10 |
| 97803 |
|
234 |
230 |
$471.21 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
46 |
18 |
$447.04 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,728 |
1,720 |
$418.08 |
| 81003 |
|
2,162 |
2,073 |
$333.48 |
| 92551 |
|
564 |
527 |
$303.14 |
| 96151 |
|
56 |
56 |
$287.63 |
| 99381 |
|
90 |
90 |
$269.28 |
| 90648 |
|
141 |
141 |
$261.00 |
| 90651 |
|
186 |
186 |
$258.30 |
| 87340 |
|
700 |
697 |
$237.22 |
| 90715 |
|
233 |
231 |
$232.14 |
| 83690 |
|
216 |
179 |
$229.85 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,139 |
1,099 |
$214.14 |
| 90647 |
|
261 |
229 |
$207.84 |
| 97802 |
|
161 |
150 |
$206.80 |
| 3078F |
|
85 |
78 |
$204.00 |
| 88142 |
|
299 |
295 |
$203.64 |
| 84702 |
|
384 |
322 |
$195.74 |
| 90649 |
|
132 |
116 |
$174.91 |
| 85652 |
|
400 |
396 |
$168.05 |
| 85730 |
|
417 |
394 |
$160.15 |
| 86900 |
|
480 |
453 |
$159.38 |
| 90688 |
|
61 |
60 |
$154.56 |
| 87806 |
|
27 |
27 |
$153.30 |
| 82728 |
|
357 |
355 |
$148.55 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
13 |
13 |
$137.05 |
| 83540 |
|
379 |
377 |
$134.72 |
| 82570 |
|
773 |
760 |
$132.49 |
| 83550 |
|
363 |
362 |
$130.23 |
| 99173 |
|
1,682 |
1,638 |
$129.81 |
| 96150 |
|
12 |
12 |
$124.95 |
| 90716 |
|
231 |
231 |
$124.91 |
| 71045 |
Radiologic examination, chest; single view |
16 |
15 |
$119.25 |
| 86706 |
|
254 |
253 |
$114.05 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
57 |
57 |
$99.00 |
| 84439 |
|
2,034 |
2,018 |
$98.26 |
| 87186 |
|
359 |
354 |
$96.17 |
| 90657 |
|
93 |
91 |
$95.40 |
| 87088 |
|
254 |
251 |
$95.28 |
| 85610 |
|
570 |
497 |
$95.04 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
111 |
108 |
$92.80 |
| 90713 |
|
94 |
86 |
$90.00 |
| 86901 |
|
448 |
423 |
$89.52 |
| 85007 |
|
121 |
82 |
$85.48 |
| 86803 |
|
405 |
404 |
$83.88 |
| 86580 |
|
51 |
50 |
$79.93 |
| 84153 |
|
79 |
79 |
$78.55 |
| 80076 |
|
432 |
426 |
$77.36 |
| 82043 |
|
795 |
783 |
$72.43 |
| 90723 |
|
135 |
135 |
$72.00 |
| 3079F |
|
47 |
45 |
$68.00 |
| 87210 |
|
19 |
18 |
$67.57 |
| 86850 |
|
343 |
338 |
$64.34 |
| 90680 |
|
83 |
80 |
$63.00 |
| 84436 |
|
902 |
896 |
$60.70 |
| 87070 |
|
210 |
204 |
$58.47 |
| 82977 |
|
295 |
289 |
$56.00 |
| 86480 |
|
14 |
14 |
$54.49 |
| 84484 |
|
80 |
52 |
$48.80 |
| 83615 |
|
296 |
291 |
$40.87 |
| 86038 |
|
214 |
213 |
$39.23 |
| 84550 |
|
502 |
493 |
$33.79 |
| 81000 |
|
388 |
378 |
$33.44 |
| 83655 |
|
512 |
510 |
$30.72 |
| 87081 |
|
312 |
311 |
$28.26 |
| 82465 |
|
186 |
185 |
$28.00 |
| 82607 |
|
93 |
92 |
$26.53 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
38 |
$25.94 |
| 96158 |
|
24 |
24 |
$25.24 |
| 87077 |
|
52 |
52 |
$23.78 |
| 83735 |
|
78 |
31 |
$19.23 |
| 82105 |
|
26 |
25 |
$15.00 |
| 82274 |
|
156 |
156 |
$14.29 |
| 82746 |
|
43 |
42 |
$13.12 |
| 96156 |
|
261 |
256 |
$12.62 |
| 84100 |
|
314 |
292 |
$12.08 |
| 90710 |
|
49 |
43 |
$9.00 |
| 90633 |
|
73 |
64 |
$9.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
13 |
13 |
$7.58 |
| 82950 |
|
363 |
360 |
$7.52 |
| 86140 |
|
124 |
123 |
$4.58 |
| 82947 |
|
228 |
228 |
$3.11 |
| 92499 |
|
128 |
128 |
$1.51 |
| 96127 |
|
114 |
114 |
$0.00 |
| 87510 |
|
358 |
356 |
$0.00 |
| 84479 |
|
372 |
371 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
209 |
199 |
$0.00 |
| 59430 |
|
51 |
51 |
$0.00 |
| 99252 |
|
26 |
26 |
$0.00 |
| 86762 |
|
245 |
244 |
$0.00 |
| 87480 |
|
358 |
356 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
27 |
26 |
$0.00 |
| 90696 |
|
30 |
30 |
$0.00 |
| 83002 |
|
14 |
14 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
25 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
552 |
546 |
$0.00 |
| 82951 |
|
15 |
14 |
$0.00 |
| 83001 |
|
42 |
42 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12 |
12 |
$0.00 |
| 90656 |
|
57 |
57 |
$0.00 |
| 84478 |
|
94 |
94 |
$0.00 |
| 86695 |
|
16 |
16 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
13 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
31 |
31 |
$0.00 |
| 90634 |
|
51 |
51 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
13 |
13 |
$0.00 |
| 0761 |
|
40 |
38 |
$0.00 |
| 84480 |
|
48 |
48 |
$0.00 |
| 83020 |
|
13 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,031 |
1,027 |
$0.00 |
| 87660 |
|
358 |
356 |
$0.00 |
| 90461 |
|
519 |
516 |
$0.00 |
| 80074 |
|
234 |
234 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
92 |
92 |
$0.00 |
| 83037 |
|
117 |
117 |
$0.00 |
| 86696 |
|
17 |
17 |
$0.00 |
| 86431 |
|
191 |
191 |
$0.00 |
| 85014 |
|
205 |
204 |
$0.00 |
| G9920 |
Screening performed and negative |
276 |
276 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 83013 |
|
50 |
50 |
$0.00 |
| 86003 |
|
140 |
139 |
$0.00 |
| T1017 |
Targeted case management, each 15 minutes |
801 |
794 |
$0.00 |
| 86677 |
|
25 |
25 |
$0.00 |
| 84460 |
|
17 |
17 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
94 |
94 |
$0.00 |
| 84146 |
|
38 |
37 |
$0.00 |
| 82785 |
|
73 |
73 |
$0.00 |
| 84450 |
|
16 |
16 |
$0.00 |
| 90658 |
|
25 |
25 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
16 |
16 |
$0.00 |
| 1160F |
|
59 |
55 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
48 |
48 |
$0.00 |
| 86703 |
|
17 |
17 |
$0.00 |
| 87338 |
|
12 |
12 |
$0.00 |
| 90621 |
|
12 |
12 |
$0.00 |