| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
30,213 |
26,021 |
$2.36M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
33,409 |
30,593 |
$2.19M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
38,797 |
36,456 |
$1.76M |
| T1017 |
Targeted case management, each 15 minutes |
34,967 |
5,033 |
$1.34M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
53,687 |
19,564 |
$1.30M |
| T1015 |
Clinic visit/encounter, all-inclusive |
15,764 |
14,220 |
$1.06M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,098 |
21,702 |
$942K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,969 |
15,207 |
$680K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
12,962 |
5,291 |
$606K |
| H1000 |
Prenatal care, at-risk assessment |
10,962 |
7,635 |
$578K |
| 99222 |
Initial hospital care, per day, moderate complexity |
5,930 |
4,869 |
$576K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,484 |
4,980 |
$473K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,671 |
4,382 |
$406K |
| 99223 |
Prolong inpt eval add15 m |
2,945 |
2,384 |
$287K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,815 |
2,655 |
$237K |
| H0032 |
Mental health service plan development by non-physician |
5,794 |
5,255 |
$228K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
4,845 |
4,170 |
$203K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
45,238 |
34,172 |
$160K |
| H2012 |
Behavioral health day treatment, per hour |
5,323 |
411 |
$143K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,289 |
1,225 |
$120K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,991 |
1,590 |
$91K |
| H2000 |
Comprehensive multidisciplinary evaluation |
328 |
307 |
$89K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,602 |
2,428 |
$86K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
803 |
737 |
$86K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,092 |
1,808 |
$74K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,952 |
4,491 |
$66K |
| H0031 |
Mental health assessment, by non-physician |
1,392 |
805 |
$56K |
| 59430 |
|
813 |
738 |
$55K |
| 95819 |
|
2,359 |
1,681 |
$47K |
| 99233 |
Prolong inpt eval add15 m |
1,336 |
550 |
$47K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
497 |
482 |
$44K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
3,466 |
1,456 |
$43K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
505 |
451 |
$42K |
| 99221 |
|
313 |
247 |
$38K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,428 |
1,141 |
$35K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
496 |
471 |
$34K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,478 |
4,202 |
$34K |
| 99460 |
|
298 |
283 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
339 |
284 |
$21K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,794 |
2,604 |
$20K |
| 99220 |
|
308 |
251 |
$20K |
| 76818 |
|
607 |
433 |
$19K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
151 |
118 |
$14K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
521 |
487 |
$12K |
| 99254 |
|
157 |
136 |
$10K |
| 99215 |
Prolong outpt/office vis |
225 |
177 |
$10K |
| 76801 |
|
129 |
121 |
$9K |
| 99381 |
|
114 |
111 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
316 |
306 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
154 |
129 |
$8K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
281 |
254 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
88 |
75 |
$4K |
| 97597 |
|
347 |
188 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
25 |
25 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
138 |
122 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
24 |
24 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
33 |
28 |
$1K |
| 99217 |
|
22 |
22 |
$1K |
| 90899 |
|
72 |
71 |
$1K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
46 |
26 |
$992.07 |
| 87428 |
|
27 |
27 |
$811.39 |
| 99382 |
|
14 |
12 |
$750.12 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
33 |
33 |
$638.22 |
| 99219 |
|
12 |
12 |
$610.23 |
| 1036F |
|
18,463 |
14,414 |
$511.50 |
| 99225 |
|
17 |
12 |
$448.47 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
29 |
27 |
$368.71 |
| 85018 |
|
488 |
460 |
$294.87 |
| 1126F |
|
12,693 |
10,877 |
$240.22 |
| 76820 |
|
19 |
12 |
$230.83 |
| 81025 |
|
103 |
98 |
$223.85 |
| 1159F |
|
16,928 |
13,867 |
$204.18 |
| 99497 |
|
215 |
143 |
$199.05 |
| 81003 |
|
334 |
259 |
$159.67 |
| 3074F |
|
19,010 |
16,545 |
$100.00 |
| 1125F |
|
463 |
384 |
$89.54 |
| 3008F |
|
29,319 |
24,687 |
$79.51 |
| 87807 |
|
13 |
13 |
$77.60 |
| 90682 |
|
35 |
35 |
$75.05 |
| 99406 |
|
57 |
50 |
$72.13 |
| 90670 |
|
749 |
672 |
$54.01 |
| 96127 |
|
38 |
35 |
$46.30 |
| 92015 |
Determination of refractive state |
102 |
78 |
$41.98 |
| 90680 |
|
376 |
358 |
$30.00 |
| 90651 |
|
30 |
30 |
$20.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
88 |
59 |
$19.85 |
| 90698 |
|
267 |
256 |
$10.00 |
| 92133 |
|
14 |
12 |
$0.78 |
| 90744 |
|
79 |
78 |
$0.00 |
| 90697 |
|
479 |
449 |
$0.00 |
| 3079F |
|
604 |
528 |
$0.00 |
| 90723 |
|
17 |
12 |
$0.00 |
| 3075F |
|
58 |
53 |
$0.00 |
| 1034F |
|
35 |
27 |
$0.00 |
| 90686 |
|
73 |
72 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 90656 |
|
16 |
16 |
$0.00 |
| 1160F |
|
19,327 |
16,072 |
$0.00 |
| 3078F |
|
18,588 |
15,626 |
$0.00 |
| 90633 |
|
192 |
173 |
$0.00 |
| 3725F |
|
2,930 |
2,420 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 90671 |
|
309 |
297 |
$0.00 |
| 3077F |
|
46 |
38 |
$0.00 |
| 90715 |
|
16 |
14 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 90630 |
|
12 |
12 |
$0.00 |