| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
34,495 |
26,132 |
$1.82M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,004 |
9,769 |
$432K |
| 99199 |
Unlisted special service, procedure or report |
31,902 |
19,470 |
$196K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,325 |
1,958 |
$148K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
2,204 |
1,666 |
$147K |
| 94375 |
|
7,998 |
6,218 |
$127K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,463 |
1,200 |
$111K |
| G0481 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed |
1,085 |
935 |
$106K |
| 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 |
995 |
707 |
$64K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,671 |
3,912 |
$63K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,065 |
1,510 |
$53K |
| 99406 |
|
7,921 |
6,130 |
$50K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
861 |
633 |
$36K |
| 83970 |
|
719 |
568 |
$32K |
| 99442 |
|
831 |
513 |
$26K |
| 99215 |
Prolong outpt/office vis |
374 |
309 |
$24K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
744 |
592 |
$23K |
| 36415 |
Collection of venous blood by venipuncture |
14,943 |
11,487 |
$23K |
| 93000 |
|
2,233 |
1,783 |
$21K |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
985 |
703 |
$21K |
| 86769 |
|
531 |
453 |
$20K |
| 71046 |
Radiologic examination, chest; 2 views |
1,364 |
1,081 |
$18K |
| 99401 |
|
741 |
519 |
$17K |
| 91200 |
|
808 |
673 |
$15K |
| 80061 |
Lipid panel |
943 |
754 |
$13K |
| 80053 |
Comprehensive metabolic panel |
1,317 |
1,078 |
$12K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,312 |
1,072 |
$11K |
| 81025 |
|
1,765 |
1,289 |
$10K |
| 82962 |
|
7,248 |
5,374 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
237 |
172 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
769 |
620 |
$7K |
| 84480 |
|
464 |
372 |
$7K |
| 99443 |
|
125 |
77 |
$7K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
57 |
42 |
$5K |
| 46221 |
|
83 |
64 |
$5K |
| 82607 |
|
315 |
257 |
$5K |
| 90756 |
|
471 |
343 |
$5K |
| 84439 |
|
490 |
396 |
$5K |
| 84443 |
Thyroid stimulating hormone (TSH) |
282 |
233 |
$5K |
| 82746 |
|
300 |
242 |
$4K |
| 82728 |
|
315 |
257 |
$4K |
| 72100 |
|
273 |
208 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
733 |
553 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
94 |
80 |
$4K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
43 |
43 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
80 |
56 |
$4K |
| 81002 |
|
2,909 |
2,174 |
$3K |
| 83550 |
|
315 |
257 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
29 |
28 |
$3K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
15 |
13 |
$2K |
| 86703 |
|
212 |
167 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
129 |
90 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
851 |
656 |
$2K |
| 83540 |
|
296 |
244 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,264 |
1,754 |
$1K |
| 73630 |
|
248 |
132 |
$1K |
| 82044 |
|
525 |
402 |
$1K |
| 11721 |
|
408 |
326 |
$1K |
| 86803 |
|
70 |
56 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,379 |
1,857 |
$751.10 |
| 90688 |
|
216 |
154 |
$737.55 |
| 87340 |
|
70 |
56 |
$642.88 |
| 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) |
302 |
240 |
$574.33 |
| 96103 |
|
559 |
463 |
$435.38 |
| 96146 |
|
1,731 |
1,377 |
$415.27 |
| 80050 |
General health panel |
30 |
28 |
$318.64 |
| 3044F |
|
3,285 |
2,587 |
$260.00 |
| 83735 |
|
37 |
25 |
$246.92 |
| 90661 |
|
29 |
23 |
$195.90 |
| 99490 |
Ccm add 20min |
48 |
25 |
$158.03 |
| 86431 |
|
12 |
12 |
$84.00 |
| 84550 |
|
12 |
12 |
$66.84 |
| 3079F |
|
2,991 |
2,397 |
$17.49 |
| 2028F |
|
208 |
173 |
$8.66 |
| 3008F |
|
11,814 |
9,193 |
$0.00 |
| 3075F |
|
1,150 |
955 |
$0.00 |
| 3049F |
|
1,355 |
1,073 |
$0.00 |
| 3048F |
|
2,653 |
2,204 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
964 |
688 |
$0.00 |
| 1125F |
|
227 |
210 |
$0.00 |
| 3074F |
|
7,319 |
5,631 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
209 |
179 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
336 |
287 |
$0.00 |
| 1170F |
|
76 |
61 |
$0.00 |
| G0296 |
Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) |
66 |
55 |
$0.00 |
| 3078F |
|
6,673 |
5,202 |
$0.00 |
| 3077F |
|
776 |
644 |
$0.00 |
| 3288F |
|
101 |
86 |
$0.00 |
| 4004F |
|
1,714 |
1,390 |
$0.00 |
| 3050F |
|
462 |
371 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
79 |
59 |
$0.00 |
| 11056 |
|
29 |
25 |
$0.00 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
281 |
244 |
$0.00 |
| 1159F |
|
83 |
71 |
$0.00 |