| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49,829 |
47,781 |
$2.65M |
| 99233 |
Prolong inpt eval add15 m |
17,788 |
7,081 |
$1.13M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,772 |
18,084 |
$728K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
7,303 |
7,066 |
$695K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
11,089 |
5,130 |
$536K |
| 99215 |
Prolong outpt/office vis |
6,419 |
6,099 |
$503K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
7,506 |
7,294 |
$481K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
3,560 |
3,455 |
$475K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,179 |
3,087 |
$336K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,534 |
1,411 |
$270K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
4,337 |
4,189 |
$267K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
887 |
853 |
$210K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
2,394 |
1,795 |
$203K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,425 |
1,402 |
$184K |
| 99205 |
Prolong outpt/office vis |
1,674 |
1,557 |
$166K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,618 |
1,527 |
$155K |
| 99222 |
Initial hospital care, per day, moderate complexity |
1,449 |
1,403 |
$152K |
| 99223 |
Prolong inpt eval add15 m |
994 |
936 |
$127K |
| 94010 |
|
5,410 |
5,125 |
$125K |
| 99255 |
|
790 |
722 |
$123K |
| D8670 |
Periodic orthodontic treatment visit |
3,152 |
2,532 |
$114K |
| 92015 |
Determination of refractive state |
5,525 |
5,394 |
$93K |
| 92567 |
|
7,428 |
6,965 |
$90K |
| 95816 |
|
317 |
304 |
$87K |
| 95720 |
|
611 |
424 |
$87K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,167 |
1,120 |
$87K |
| 92060 |
|
1,548 |
1,514 |
$87K |
| 95782 |
|
673 |
640 |
$69K |
| 99245 |
|
341 |
320 |
$60K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
695 |
668 |
$54K |
| 95812 |
|
246 |
211 |
$54K |
| 99243 |
|
589 |
557 |
$52K |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
141 |
38 |
$50K |
| 94060 |
|
1,184 |
1,157 |
$46K |
| 95819 |
|
113 |
111 |
$38K |
| 92582 |
|
637 |
604 |
$38K |
| 96112 |
|
340 |
328 |
$37K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
170 |
63 |
$35K |
| 92579 |
|
896 |
855 |
$34K |
| 99292 |
|
291 |
153 |
$30K |
| 17110 |
|
333 |
316 |
$30K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,360 |
3,273 |
$28K |
| 99217 |
|
499 |
477 |
$28K |
| 92504 |
|
1,153 |
1,101 |
$23K |
| 99254 |
|
168 |
155 |
$21K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,703 |
1,579 |
$19K |
| 95117 |
|
1,410 |
907 |
$14K |
| 99000 |
|
1,251 |
1,213 |
$13K |
| 92587 |
|
752 |
702 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
936 |
827 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
229 |
224 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
138 |
126 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,030 |
364 |
$10K |
| 92557 |
|
284 |
267 |
$8K |
| 99219 |
|
67 |
63 |
$6K |
| 92583 |
|
162 |
155 |
$6K |
| 99417 |
Prolong home eval add 15m |
304 |
280 |
$6K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
44 |
41 |
$5K |
| 17111 |
|
39 |
39 |
$5K |
| 31575 |
|
43 |
43 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
14 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
50 |
39 |
$4K |
| 69210 |
|
95 |
91 |
$3K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
38 |
38 |
$3K |
| 99242 |
|
39 |
38 |
$3K |
| 99220 |
|
12 |
12 |
$2K |
| 92555 |
|
73 |
72 |
$2K |
| 92588 |
|
54 |
53 |
$2K |
| 87428 |
|
46 |
44 |
$1K |
| 42830 |
|
12 |
12 |
$1K |
| 92604 |
|
18 |
14 |
$1K |
| 92002 |
|
16 |
16 |
$1K |
| 81025 |
|
161 |
158 |
$1K |
| 99253 |
|
13 |
12 |
$1K |
| 31622 |
|
12 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
37 |
36 |
$858.21 |
| 92552 |
|
26 |
26 |
$753.92 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
53 |
33 |
$657.94 |
| 81002 |
|
172 |
159 |
$495.29 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
96 |
94 |
$422.15 |
| 90686 |
|
1,006 |
947 |
$339.09 |
| 90480 |
|
31 |
25 |
$312.40 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$305.80 |
| 95115 |
|
20 |
12 |
$155.88 |
| 3008F |
|
26,111 |
24,907 |
$0.53 |
| 1036F |
|
17,724 |
16,870 |
$0.44 |
| 3078F |
|
10,228 |
9,666 |
$0.18 |
| 3074F |
|
10,223 |
9,667 |
$0.18 |
| 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) |
68 |
63 |
$0.11 |
| 1160F |
|
36,477 |
34,924 |
$0.02 |
| 1159F |
|
21,730 |
20,672 |
$0.00 |
| 90661 |
|
43 |
41 |
$0.00 |
| 90670 |
|
43 |
38 |
$0.00 |
| 3725F |
|
18 |
18 |
$0.00 |
| 90648 |
|
56 |
50 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 99024 |
|
728 |
609 |
$0.00 |
| J3590 |
Unclassified biologics |
701 |
656 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |
| 1126F |
|
175 |
158 |
$0.00 |
| J3490 |
Unclassified drugs |
14 |
12 |
$0.00 |
| 96127 |
|
13 |
12 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |