| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
76,287 |
58,391 |
$3.86M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54,975 |
41,543 |
$1.84M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12,549 |
10,237 |
$1.18M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15,414 |
12,199 |
$732K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
11,094 |
9,310 |
$385K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
11,181 |
4,090 |
$327K |
| 99222 |
Initial hospital care, per day, moderate complexity |
5,018 |
3,822 |
$321K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
511 |
412 |
$302K |
| 99215 |
Prolong outpt/office vis |
4,324 |
3,426 |
$259K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,548 |
1,332 |
$223K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,438 |
1,939 |
$193K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,257 |
1,818 |
$162K |
| 93000 |
|
26,063 |
20,668 |
$155K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,337 |
1,562 |
$151K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,793 |
6,279 |
$146K |
| 99223 |
Prolong inpt eval add15 m |
1,641 |
1,299 |
$145K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
576 |
489 |
$115K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,630 |
1,336 |
$114K |
| 99442 |
|
2,642 |
2,281 |
$110K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,981 |
1,523 |
$103K |
| 20610 |
|
3,713 |
3,010 |
$97K |
| 99233 |
Prolong inpt eval add15 m |
1,855 |
1,078 |
$92K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
3,841 |
1,926 |
$79K |
| 99221 |
|
1,702 |
1,421 |
$73K |
| 31575 |
|
1,312 |
998 |
$68K |
| 99460 |
|
961 |
719 |
$66K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
264 |
212 |
$64K |
| 59514 |
|
87 |
74 |
$59K |
| 92557 |
|
3,439 |
2,664 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,078 |
708 |
$56K |
| 20611 |
|
721 |
622 |
$48K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,636 |
4,803 |
$43K |
| 99205 |
Prolong outpt/office vis |
325 |
290 |
$42K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,230 |
1,046 |
$40K |
| 90677 |
|
1,154 |
613 |
$40K |
| 99495 |
|
524 |
436 |
$40K |
| 90686 |
|
4,613 |
3,518 |
$38K |
| 95251 |
|
1,358 |
1,184 |
$33K |
| 92567 |
|
4,588 |
3,536 |
$29K |
| 99441 |
|
1,392 |
1,160 |
$28K |
| 93295 |
|
1,174 |
968 |
$25K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,785 |
1,420 |
$22K |
| 99443 |
|
1,050 |
939 |
$22K |
| 99406 |
|
3,760 |
2,736 |
$21K |
| 93296 |
|
2,276 |
1,867 |
$19K |
| 87428 |
|
584 |
444 |
$19K |
| 95115 |
|
3,713 |
1,219 |
$18K |
| 93298 |
|
1,410 |
1,141 |
$18K |
| 90715 |
|
991 |
794 |
$17K |
| 93297 |
|
1,460 |
1,201 |
$16K |
| 99490 |
Ccm add 20min |
1,034 |
823 |
$15K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
1,416 |
1,101 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,212 |
983 |
$12K |
| 93018 |
|
1,636 |
1,382 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,353 |
1,969 |
$11K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
3,620 |
3,025 |
$11K |
| 81002 |
|
7,184 |
5,183 |
$11K |
| S0612 |
Annual gynecological examination, established patient |
207 |
156 |
$10K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
60 |
50 |
$10K |
| 51798 |
|
1,808 |
1,407 |
$9K |
| 93458 |
|
44 |
40 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,179 |
801 |
$7K |
| 93227 |
|
510 |
444 |
$7K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
280 |
189 |
$6K |
| 31231 |
|
38 |
31 |
$6K |
| 95117 |
|
1,183 |
371 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
87 |
66 |
$5K |
| 90834 |
Psychotherapy, 45 minutes with patient |
87 |
63 |
$5K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
112 |
108 |
$5K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
117 |
88 |
$5K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
56 |
56 |
$4K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
68 |
56 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
212 |
154 |
$4K |
| 85610 |
|
2,347 |
1,374 |
$4K |
| 59430 |
|
22 |
14 |
$4K |
| 81025 |
|
970 |
768 |
$4K |
| 69210 |
|
250 |
164 |
$4K |
| 90732 |
|
162 |
115 |
$4K |
| 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) |
1,507 |
1,282 |
$3K |
| 93294 |
|
456 |
366 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
49 |
39 |
$3K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
797 |
609 |
$3K |
| 59025 |
Fetal non-stress test |
187 |
136 |
$3K |
| 90670 |
|
144 |
134 |
$3K |
| 93016 |
|
400 |
318 |
$2K |
| 52000 |
|
62 |
26 |
$2K |
| G0179 |
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
148 |
114 |
$2K |
| 83655 |
|
444 |
224 |
$2K |
| 93308 |
|
115 |
93 |
$2K |
| 99462 |
|
55 |
43 |
$2K |
| 90656 |
|
323 |
300 |
$2K |
| 90681 |
|
348 |
205 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
74 |
45 |
$1K |
| 90750 |
|
65 |
39 |
$1K |
| 93880 |
|
42 |
39 |
$1K |
| 90648 |
|
554 |
323 |
$1K |
| G0180 |
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
64 |
54 |
$1K |
| 92504 |
|
67 |
60 |
$1K |
| 99496 |
|
96 |
71 |
$1K |
| 90723 |
|
444 |
254 |
$1K |
| 81003 |
|
833 |
697 |
$1K |
| 93299 |
|
114 |
97 |
$1K |
| 90698 |
|
50 |
50 |
$946.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
213 |
176 |
$821.46 |
| 93015 |
|
15 |
13 |
$775.08 |
| 51741 |
|
190 |
131 |
$728.26 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
74 |
47 |
$716.95 |
| 90662 |
|
664 |
567 |
$706.37 |
| 54150 |
|
14 |
12 |
$687.36 |
| 20550 |
|
39 |
27 |
$560.96 |
| 99152 |
|
32 |
26 |
$553.50 |
| 93290 |
|
30 |
26 |
$548.98 |
| 92558 |
|
75 |
58 |
$499.13 |
| 90633 |
|
182 |
115 |
$478.55 |
| 90651 |
|
17 |
15 |
$418.18 |
| 90744 |
|
26 |
25 |
$417.12 |
| G0506 |
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) |
22 |
14 |
$416.91 |
| 59200 |
|
18 |
15 |
$416.20 |
| 99177 |
|
664 |
385 |
$414.40 |
| 85018 |
|
471 |
226 |
$411.61 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
19,459 |
14,626 |
$255.91 |
| 95800 |
|
17 |
12 |
$253.26 |
| S0610 |
Annual gynecological examination, new patient |
27 |
13 |
$187.89 |
| 99173 |
|
173 |
101 |
$178.72 |
| 3075F |
|
4,033 |
3,095 |
$159.49 |
| 3078F |
|
7,928 |
5,897 |
$159.49 |
| 92551 |
|
40 |
14 |
$157.61 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
57 |
51 |
$141.22 |
| 99385 |
|
63 |
42 |
$136.18 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
5,669 |
4,585 |
$131.27 |
| 3080F |
|
2,276 |
1,671 |
$128.50 |
| 1111F |
|
632 |
490 |
$126.39 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
16,576 |
12,486 |
$124.66 |
| 90707 |
|
19 |
12 |
$100.54 |
| 86580 |
|
36 |
24 |
$82.66 |
| G0008 |
Administration of influenza virus vaccine |
1,133 |
970 |
$59.76 |
| 93793 |
|
694 |
335 |
$57.32 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
204 |
104 |
$42.85 |
| G0009 |
Administration of pneumococcal vaccine |
66 |
50 |
$27.29 |
| 90700 |
|
22 |
13 |
$8.08 |
| 3044F |
|
5,772 |
4,152 |
$0.04 |
| 90381 |
|
14 |
13 |
$0.03 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
2,781 |
2,231 |
$0.02 |
| 3008F |
|
24,812 |
19,254 |
$0.02 |
| 3046F |
|
8,207 |
5,864 |
$0.02 |
| 3051F |
|
2,523 |
1,896 |
$0.01 |
| G8598 |
Aspirin or another antiplatelet therapy used |
244 |
224 |
$0.01 |
| 3052F |
|
1,167 |
893 |
$0.00 |
| 1220F |
|
1,405 |
1,045 |
$0.00 |
| 3079F |
|
5,925 |
4,437 |
$0.00 |
| 3074F |
|
8,481 |
6,239 |
$0.00 |
| 76820 |
|
17 |
13 |
$0.00 |
| 82962 |
|
416 |
332 |
$0.00 |
| 1125F |
|
124 |
116 |
$0.00 |
| 1126F |
|
118 |
111 |
$0.00 |
| 99386 |
|
16 |
12 |
$0.00 |
| 90461 |
|
1,816 |
1,145 |
$0.00 |
| 3077F |
|
3,955 |
2,956 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,554 |
2,517 |
$0.00 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
14 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
25 |
12 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
78 |
57 |
$0.00 |
| 76821 |
|
18 |
14 |
$0.00 |