| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
461,305 |
422,458 |
$20.82M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
155,298 |
144,030 |
$8.03M |
| G9012 |
Other specified case management service not elsewhere classified |
47,419 |
34,337 |
$6.48M |
| 59425 |
|
46,456 |
32,551 |
$4.17M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
109,616 |
100,751 |
$3.34M |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
18,485 |
13,237 |
$2.29M |
| 90791 |
Psychiatric diagnostic evaluation |
11,392 |
11,143 |
$1.80M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
22,186 |
21,569 |
$1.37M |
| 90832 |
Psychotherapy, 30 minutes with patient |
24,735 |
20,435 |
$1.11M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15,559 |
15,227 |
$992K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
19,255 |
18,900 |
$964K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15,229 |
14,309 |
$887K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
10,655 |
10,402 |
$834K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
7,039 |
6,784 |
$820K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
10,040 |
9,888 |
$782K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
6,366 |
6,306 |
$739K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
16,443 |
15,860 |
$665K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
3,366 |
3,312 |
$474K |
| 90686 |
|
28,441 |
28,181 |
$416K |
| 90715 |
|
11,296 |
11,109 |
$361K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
7,314 |
7,147 |
$348K |
| 90739 |
|
2,942 |
2,801 |
$295K |
| 90750 |
|
1,800 |
1,789 |
$291K |
| 90677 |
|
5,837 |
5,286 |
$273K |
| 90651 |
|
10,258 |
10,120 |
$254K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,443 |
2,399 |
$228K |
| 99205 |
Prolong outpt/office vis |
1,319 |
1,273 |
$207K |
| 92250 |
|
5,394 |
5,367 |
$206K |
| 90707 |
|
10,002 |
9,828 |
$194K |
| 96156 |
|
13,702 |
13,623 |
$183K |
| 90746 |
|
2,057 |
2,043 |
$177K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
8,259 |
7,514 |
$175K |
| 90670 |
|
13,567 |
13,453 |
$165K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
227 |
209 |
$153K |
| 90688 |
|
7,511 |
7,477 |
$150K |
| 90716 |
|
9,473 |
9,294 |
$139K |
| 99188 |
|
6,845 |
6,617 |
$129K |
| 99401 |
|
8,561 |
8,218 |
$127K |
| 90633 |
|
11,504 |
11,116 |
$123K |
| 97803 |
|
9,990 |
9,652 |
$120K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
11,010 |
9,180 |
$115K |
| 90734 |
|
7,370 |
7,300 |
$114K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,150 |
2,018 |
$108K |
| 92551 |
|
7,759 |
7,557 |
$104K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16,167 |
15,756 |
$103K |
| 99381 |
|
1,279 |
1,210 |
$94K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17,806 |
17,296 |
$92K |
| 90648 |
|
8,544 |
7,779 |
$92K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,069 |
953 |
$91K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,546 |
1,530 |
$90K |
| 90680 |
|
8,250 |
7,883 |
$89K |
| 90698 |
|
7,889 |
7,801 |
$87K |
| 99385 |
|
780 |
762 |
$86K |
| 99215 |
Prolong outpt/office vis |
1,378 |
1,290 |
$86K |
| 59430 |
|
1,148 |
1,093 |
$86K |
| 97802 |
|
5,095 |
4,921 |
$85K |
| 81025 |
|
30,075 |
28,851 |
$83K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,752 |
6,580 |
$79K |
| 99383 |
|
1,038 |
1,013 |
$77K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
167 |
149 |
$70K |
| 92552 |
|
3,105 |
2,990 |
$69K |
| 81002 |
|
44,218 |
40,216 |
$66K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
1,833 |
1,832 |
$64K |
| J3490 |
Unclassified drugs |
1,515 |
1,436 |
$62K |
| 90736 |
|
284 |
282 |
$61K |
| 90744 |
|
5,475 |
5,430 |
$59K |
| 93000 |
|
1,784 |
1,751 |
$59K |
| 90723 |
|
5,382 |
4,787 |
$58K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,958 |
7,656 |
$56K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
2,191 |
2,161 |
$53K |
| 90656 |
|
3,208 |
2,985 |
$53K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,062 |
1,061 |
$51K |
| 99173 |
|
11,954 |
11,547 |
$50K |
| 99460 |
|
786 |
782 |
$49K |
| 90837 |
Psychotherapy, 53 minutes with patient |
612 |
489 |
$48K |
| 90700 |
|
4,382 |
4,272 |
$48K |
| 99384 |
|
516 |
504 |
$47K |
| 83655 |
|
4,372 |
4,136 |
$46K |
| H1000 |
Prenatal care, at-risk assessment |
2,406 |
2,111 |
$41K |
| 90658 |
|
1,437 |
1,351 |
$39K |
| 90732 |
|
646 |
643 |
$37K |
| 11981 |
|
138 |
129 |
$35K |
| 99386 |
|
356 |
349 |
$34K |
| H2000 |
Comprehensive multidisciplinary evaluation |
2,378 |
2,364 |
$33K |
| G9007 |
Coordinated care fee, scheduled team conference |
632 |
627 |
$31K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
643 |
515 |
$30K |
| 82962 |
|
15,833 |
15,088 |
$30K |
| S9452 |
Nutrition classes, non-physician provider, per session |
2,276 |
2,241 |
$28K |
| 90756 |
|
1,481 |
1,432 |
$26K |
| 85018 |
|
15,466 |
14,883 |
$26K |
| 99382 |
|
413 |
402 |
$25K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,158 |
791 |
$24K |
| 96150 |
|
1,437 |
1,219 |
$23K |
| 99000 |
|
10,267 |
9,843 |
$22K |
| 71046 |
Radiologic examination, chest; 2 views |
1,130 |
1,111 |
$21K |
| 86580 |
|
5,981 |
5,807 |
$19K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
228 |
228 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,868 |
5,516 |
$19K |
| 99201 |
|
647 |
645 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
376 |
375 |
$17K |
| 99462 |
|
492 |
448 |
$16K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
619 |
556 |
$15K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,022 |
1,928 |
$14K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
213 |
213 |
$13K |
| 90696 |
|
1,146 |
1,127 |
$12K |
| 90685 |
|
1,071 |
1,064 |
$12K |
| 90713 |
|
928 |
910 |
$11K |
| 99242 |
|
150 |
133 |
$10K |
| 90681 |
|
840 |
680 |
$9K |
| 69210 |
|
269 |
239 |
$8K |
| 90620 |
|
668 |
660 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21,613 |
21,405 |
$8K |
| 58300 |
|
121 |
60 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
137 |
137 |
$7K |
| 76801 |
|
117 |
114 |
$7K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,059 |
998 |
$6K |
| 92015 |
Determination of refractive state |
596 |
596 |
$6K |
| 98940 |
|
257 |
189 |
$5K |
| 96151 |
|
503 |
502 |
$5K |
| 94060 |
|
98 |
94 |
$5K |
| 90678 |
|
14 |
13 |
$5K |
| 73562 |
|
309 |
238 |
$5K |
| 90682 |
|
94 |
93 |
$4K |
| 73030 |
|
229 |
203 |
$4K |
| 11976 |
|
53 |
27 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
301 |
301 |
$3K |
| 90662 |
|
93 |
93 |
$3K |
| 57454 |
|
25 |
14 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
37 |
36 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
285 |
282 |
$3K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
70 |
62 |
$2K |
| 72110 |
|
60 |
60 |
$2K |
| 72100 |
|
98 |
98 |
$2K |
| 90632 |
|
30 |
30 |
$2K |
| 74018 |
|
102 |
102 |
$2K |
| 88720 |
|
438 |
331 |
$2K |
| 96127 |
|
306 |
304 |
$2K |
| 90381 |
|
162 |
134 |
$2K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
292 |
279 |
$2K |
| 87807 |
|
193 |
178 |
$2K |
| 11982 |
|
12 |
12 |
$2K |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
97 |
95 |
$2K |
| 73560 |
|
106 |
79 |
$1K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
5,114 |
4,770 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
316 |
294 |
$1K |
| 90380 |
|
118 |
97 |
$1K |
| 81003 |
|
494 |
409 |
$1K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
82 |
80 |
$1K |
| 3078F |
|
129,992 |
115,898 |
$1K |
| 74019 |
|
41 |
41 |
$899.67 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
225 |
215 |
$836.19 |
| 73630 |
|
46 |
39 |
$778.18 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
13 |
13 |
$657.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,907 |
9,850 |
$617.75 |
| 90649 |
|
56 |
56 |
$617.25 |
| 99233 |
Prolong inpt eval add15 m |
12 |
12 |
$588.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
108 |
73 |
$564.90 |
| 90710 |
|
50 |
49 |
$545.40 |
| 73610 |
|
30 |
26 |
$512.48 |
| 3079F |
|
70,673 |
66,161 |
$492.76 |
| 92133 |
|
12 |
12 |
$483.72 |
| 90621 |
|
50 |
50 |
$472.50 |
| 90657 |
|
41 |
41 |
$436.50 |
| 73502 |
|
13 |
13 |
$382.51 |
| 87806 |
|
13 |
13 |
$364.22 |
| 72081 |
|
13 |
13 |
$329.50 |
| 90714 |
|
14 |
13 |
$260.47 |
| 72070 |
|
12 |
12 |
$255.60 |
| A9150 |
Non-prescription drugs |
141 |
139 |
$195.94 |
| A4267 |
Contraceptive supply, condom, male, each |
510 |
495 |
$189.90 |
| 73120 |
|
15 |
12 |
$171.74 |
| 90674 |
|
15 |
15 |
$162.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
16 |
16 |
$161.48 |
| 86803 |
|
13 |
13 |
$150.84 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
528 |
483 |
$145.64 |
| J1815 |
Injection, insulin, per 5 units |
26 |
26 |
$141.70 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
122 |
119 |
$128.59 |
| 99403 |
|
16 |
16 |
$123.62 |
| 87430 |
|
14 |
14 |
$114.52 |
| 69209 |
|
13 |
13 |
$86.58 |
| 36416 |
|
150 |
147 |
$23.40 |
| 3077F |
|
23,459 |
21,585 |
$16.99 |
| 3074F |
|
152,171 |
136,107 |
$10.71 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
151 |
149 |
$0.94 |
| T1015 |
Clinic visit/encounter, all-inclusive |
13 |
12 |
$0.09 |
| 3046F |
|
101 |
96 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
13 |
13 |
$0.00 |
| 2022F |
|
13 |
13 |
$0.00 |
| 3075F |
|
34,475 |
32,536 |
$0.00 |
| 3080F |
|
9,151 |
8,568 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
287 |
280 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
41 |
41 |
$0.00 |
| 3044F |
|
735 |
683 |
$0.00 |
| 3072F |
|
57 |
57 |
$0.00 |
| 2023F |
|
61 |
59 |
$0.00 |
| 88142 |
|
54 |
53 |
$0.00 |