| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,673 |
4,644 |
$645K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,923 |
10,421 |
$509K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,199 |
9,069 |
$344K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,591 |
1,586 |
$100K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,738 |
1,677 |
$99K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
785 |
735 |
$78K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
202 |
196 |
$70K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
511 |
490 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
533 |
529 |
$33K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
293 |
287 |
$33K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
541 |
510 |
$29K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,812 |
461 |
$29K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
14 |
14 |
$27K |
| 99460 |
|
322 |
320 |
$25K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
82 |
73 |
$24K |
| 59025 |
Fetal non-stress test |
157 |
78 |
$24K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
653 |
554 |
$19K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
74 |
65 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
960 |
863 |
$17K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
325 |
223 |
$12K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
109 |
74 |
$11K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
157 |
157 |
$10K |
| 90670 |
|
1,424 |
1,418 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
161 |
131 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
209 |
194 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
98 |
98 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
179 |
169 |
$6K |
| 95811 |
|
18 |
16 |
$5K |
| 90680 |
|
785 |
781 |
$5K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
135 |
37 |
$5K |
| 99215 |
Prolong outpt/office vis |
126 |
93 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
78 |
70 |
$5K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
44 |
44 |
$5K |
| 80053 |
Comprehensive metabolic panel |
594 |
508 |
$5K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
107 |
87 |
$5K |
| 90648 |
|
686 |
684 |
$4K |
| 90633 |
|
606 |
606 |
$4K |
| 76830 |
Ultrasound, transvaginal |
77 |
76 |
$4K |
| 76801 |
|
79 |
74 |
$3K |
| 90723 |
|
402 |
400 |
$3K |
| 90698 |
|
393 |
391 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13 |
13 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
25 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
199 |
198 |
$2K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
17 |
13 |
$1K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
47 |
18 |
$1K |
| 90685 |
|
191 |
191 |
$1K |
| 99462 |
|
31 |
25 |
$1K |
| 11750 |
|
16 |
13 |
$1K |
| 11721 |
|
221 |
141 |
$986.35 |
| 90744 |
|
145 |
144 |
$868.44 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
25 |
13 |
$846.40 |
| 90688 |
|
127 |
123 |
$828.44 |
| 90710 |
|
125 |
124 |
$823.60 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
766 |
656 |
$753.96 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
63 |
55 |
$739.20 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
243 |
187 |
$721.48 |
| 99381 |
|
12 |
12 |
$696.34 |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
17 |
12 |
$691.36 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
192 |
178 |
$689.83 |
| 90700 |
|
107 |
107 |
$647.38 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
77 |
76 |
$639.71 |
| 36415 |
Collection of venous blood by venipuncture |
728 |
624 |
$579.89 |
| 90707 |
|
96 |
96 |
$579.24 |
| 90686 |
|
93 |
93 |
$557.76 |
| 77072 |
|
12 |
12 |
$552.75 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$541.52 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13 |
13 |
$536.67 |
| 99221 |
|
15 |
12 |
$486.38 |
| 90716 |
|
73 |
73 |
$440.54 |
| 90734 |
|
29 |
29 |
$401.47 |
| 84484 |
|
51 |
42 |
$378.39 |
| 90651 |
|
55 |
55 |
$323.46 |
| 11056 |
|
121 |
79 |
$297.71 |
| 74018 |
|
12 |
12 |
$185.48 |
| 81025 |
|
219 |
212 |
$168.98 |
| 71045 |
Radiologic examination, chest; single view |
80 |
77 |
$163.05 |
| 83735 |
|
100 |
84 |
$145.87 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$140.98 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
12 |
12 |
$133.95 |
| 85610 |
|
133 |
129 |
$75.94 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
512 |
409 |
$59.39 |
| 81001 |
|
310 |
289 |
$45.43 |
| 86900 |
|
27 |
25 |
$43.13 |
| 85730 |
|
108 |
104 |
$36.30 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
92 |
89 |
$34.94 |
| 87430 |
|
82 |
81 |
$34.04 |
| 87081 |
|
79 |
79 |
$31.20 |
| 86901 |
|
27 |
25 |
$22.70 |
| 86140 |
|
16 |
14 |
$22.05 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
13 |
12 |
$20.62 |
| 81003 |
|
212 |
202 |
$20.36 |
| 83690 |
|
199 |
189 |
$19.82 |
| 80306 |
|
50 |
50 |
$19.74 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
173 |
170 |
$15.78 |
| 82150 |
|
139 |
133 |
$14.93 |
| 81002 |
|
43 |
43 |
$7.71 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$7.38 |
| 82962 |
|
14 |
13 |
$4.48 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
136 |
120 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
141 |
139 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
14 |
14 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
110 |
73 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
54 |
53 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
272 |
260 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
124 |
117 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
59 |
58 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
220 |
196 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
174 |
165 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
223 |
204 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
15 |
15 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
124 |
115 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
276 |
258 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
25 |
25 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
28 |
27 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
390 |
345 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
92 |
90 |
$0.00 |