| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74,749 |
67,691 |
$3.77M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45,917 |
42,920 |
$3.34M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
11,074 |
10,889 |
$675K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
6,967 |
6,850 |
$647K |
| 59426 |
|
645 |
641 |
$555K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,838 |
6,454 |
$440K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
534 |
529 |
$374K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,454 |
4,409 |
$343K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,719 |
8,463 |
$259K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,987 |
2,970 |
$242K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,652 |
2,642 |
$241K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,102 |
5,932 |
$238K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,475 |
2,472 |
$188K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,669 |
2,637 |
$174K |
| 99215 |
Prolong outpt/office vis |
1,656 |
1,624 |
$165K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
7,618 |
7,517 |
$148K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,692 |
1,689 |
$137K |
| 59430 |
|
617 |
617 |
$131K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12,442 |
12,244 |
$126K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,905 |
4,806 |
$116K |
| 99460 |
|
2,097 |
2,074 |
$112K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,359 |
1,334 |
$96K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
2,239 |
2,212 |
$93K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,110 |
2,082 |
$85K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,207 |
1,188 |
$83K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,127 |
2,073 |
$82K |
| 20610 |
|
2,062 |
1,858 |
$72K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
406 |
402 |
$56K |
| 43248 |
|
718 |
704 |
$49K |
| 90715 |
|
2,043 |
2,026 |
$48K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
270 |
269 |
$46K |
| 90682 |
|
595 |
593 |
$34K |
| 90686 |
|
3,683 |
3,648 |
$33K |
| 54150 |
|
553 |
549 |
$31K |
| 36415 |
Collection of venous blood by venipuncture |
8,176 |
7,778 |
$28K |
| 90651 |
|
806 |
803 |
$27K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,345 |
2,257 |
$27K |
| 92557 |
|
1,256 |
1,249 |
$26K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,130 |
2,730 |
$24K |
| 96127 |
|
8,031 |
7,813 |
$20K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
489 |
485 |
$20K |
| 81025 |
|
2,981 |
2,910 |
$19K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
339 |
335 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,244 |
1,072 |
$16K |
| 99441 |
|
794 |
780 |
$16K |
| 92567 |
|
1,772 |
1,759 |
$16K |
| 87634 |
|
376 |
372 |
$15K |
| 99442 |
|
423 |
414 |
$15K |
| 90473 |
|
2,147 |
2,125 |
$15K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,112 |
2,106 |
$15K |
| 99462 |
|
620 |
494 |
$14K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
108 |
104 |
$14K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
809 |
803 |
$12K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,756 |
1,697 |
$12K |
| 59425 |
|
26 |
26 |
$11K |
| 81003 |
|
6,020 |
5,816 |
$10K |
| 99205 |
Prolong outpt/office vis |
81 |
81 |
$10K |
| 99051 |
|
5,918 |
5,768 |
$9K |
| 98966 |
|
3,524 |
2,951 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
810 |
800 |
$8K |
| 90677 |
|
664 |
664 |
$8K |
| 90670 |
|
3,350 |
3,301 |
$8K |
| 99218 |
|
145 |
131 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
271 |
268 |
$7K |
| 59514 |
|
21 |
12 |
$7K |
| 90621 |
|
296 |
295 |
$7K |
| 83655 |
|
592 |
587 |
$7K |
| 90632 |
|
122 |
119 |
$7K |
| 73564 |
|
265 |
236 |
$7K |
| 90746 |
|
97 |
95 |
$5K |
| 69210 |
|
209 |
205 |
$5K |
| 99385 |
|
53 |
53 |
$5K |
| 59025 |
Fetal non-stress test |
168 |
80 |
$5K |
| 90707 |
|
780 |
767 |
$4K |
| 90673 |
|
54 |
54 |
$4K |
| 99383 |
|
42 |
42 |
$4K |
| 99443 |
|
56 |
56 |
$3K |
| 64635 |
|
17 |
12 |
$3K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
534 |
510 |
$2K |
| 99221 |
|
41 |
39 |
$2K |
| 99406 |
|
325 |
304 |
$2K |
| 58300 |
|
48 |
48 |
$2K |
| 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) |
1,094 |
1,058 |
$2K |
| 94010 |
|
128 |
128 |
$2K |
| 64636 |
|
17 |
12 |
$2K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
157 |
153 |
$2K |
| 31231 |
|
15 |
13 |
$2K |
| 90734 |
|
292 |
292 |
$2K |
| 91320 |
|
14 |
14 |
$2K |
| T1015 |
Clinic visit/encounter, all-inclusive |
33 |
27 |
$1K |
| 90656 |
|
157 |
157 |
$1K |
| 73030 |
|
80 |
77 |
$1K |
| 93016 |
|
112 |
111 |
$1K |
| 92552 |
|
76 |
76 |
$1K |
| 93000 |
|
167 |
167 |
$1K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
37 |
24 |
$1K |
| 90480 |
|
42 |
42 |
$1K |
| 99382 |
|
14 |
14 |
$1K |
| 85018 |
|
660 |
647 |
$1K |
| 99459 |
|
85 |
85 |
$1K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
830 |
662 |
$1K |
| 90716 |
|
653 |
644 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
15 |
14 |
$1K |
| 73100 |
|
61 |
52 |
$1K |
| 93018 |
|
112 |
111 |
$892.07 |
| 17110 |
|
13 |
12 |
$819.00 |
| 11982 |
|
12 |
12 |
$713.19 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
610 |
575 |
$712.01 |
| 69209 |
|
68 |
68 |
$659.34 |
| 98925 |
|
37 |
34 |
$658.13 |
| 94726 |
|
95 |
95 |
$642.72 |
| 87807 |
|
63 |
63 |
$580.49 |
| 90474 |
|
85 |
84 |
$566.18 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
87 |
80 |
$498.30 |
| 98967 |
|
121 |
111 |
$483.79 |
| 94729 |
|
96 |
96 |
$482.73 |
| 73130 |
|
20 |
16 |
$424.67 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
83 |
83 |
$420.33 |
| 95251 |
|
25 |
24 |
$418.62 |
| 99000 |
|
37 |
35 |
$362.35 |
| 99407 |
|
21 |
20 |
$306.83 |
| 73502 |
|
12 |
12 |
$301.75 |
| 90658 |
|
36 |
35 |
$259.04 |
| 96161 |
|
169 |
166 |
$179.61 |
| 94060 |
|
25 |
25 |
$172.93 |
| 82962 |
|
73 |
65 |
$166.58 |
| 90619 |
|
202 |
201 |
$156.84 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
30 |
30 |
$150.48 |
| 92587 |
|
12 |
12 |
$135.45 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
26 |
24 |
$133.13 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
36 |
36 |
$116.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
15 |
$112.00 |
| G0008 |
Administration of influenza virus vaccine |
50 |
50 |
$84.96 |
| 99188 |
|
12 |
12 |
$80.38 |
| 90662 |
|
12 |
12 |
$55.95 |
| G9002 |
Coordinated care fee, maintenance rate |
33 |
27 |
$40.52 |
| 36416 |
|
13 |
13 |
$38.40 |
| 1003F |
|
51,359 |
47,086 |
$28.57 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
54 |
54 |
$28.52 |
| 1160F |
|
92,087 |
80,655 |
$17.89 |
| 1111F |
|
1,852 |
1,732 |
$17.50 |
| 1033F |
|
43,056 |
39,140 |
$12.43 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
13 |
$12.33 |
| 3016F |
|
51,106 |
46,366 |
$6.46 |
| 1220F |
|
20,818 |
20,243 |
$5.95 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
191 |
183 |
$1.05 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
12 |
12 |
$0.75 |
| 1036F |
|
50,029 |
44,920 |
$0.53 |
| 1034F |
|
20,689 |
18,191 |
$0.00 |
| 4000F |
|
5,376 |
4,930 |
$0.00 |
| 99024 |
|
5,653 |
4,661 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
2,335 |
2,321 |
$0.00 |
| 3044F |
|
1,130 |
1,086 |
$0.00 |
| 90680 |
|
2,723 |
2,688 |
$0.00 |
| 90698 |
|
3,712 |
3,662 |
$0.00 |
| 1031F |
|
16,139 |
14,314 |
$0.00 |
| 90696 |
|
268 |
266 |
$0.00 |
| 3075F |
|
127 |
127 |
$0.00 |
| 90744 |
|
2,102 |
2,069 |
$0.00 |
| 3079F |
|
340 |
332 |
$0.00 |
| 1101F |
|
343 |
336 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
378 |
372 |
$0.00 |
| 0503F |
|
541 |
538 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
254 |
249 |
$0.00 |
| 3080F |
|
141 |
136 |
$0.00 |
| 1123F |
|
199 |
199 |
$0.00 |
| 3074F |
|
755 |
736 |
$0.00 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
43 |
25 |
$0.00 |
| 1035F |
|
24 |
24 |
$0.00 |
| 2028F |
|
1,132 |
1,051 |
$0.00 |
| 3078F |
|
590 |
578 |
$0.00 |
| 1032F |
|
7,437 |
7,015 |
$0.00 |
| 90700 |
|
41 |
41 |
$0.00 |
| 90633 |
|
1,886 |
1,857 |
$0.00 |
| 99173 |
|
298 |
298 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
7,865 |
7,613 |
$0.00 |
| 3077F |
|
169 |
162 |
$0.00 |
| 1100F |
|
291 |
286 |
$0.00 |
| 90685 |
|
206 |
190 |
$0.00 |
| 3046F |
|
51 |
50 |
$0.00 |
| 90710 |
|
351 |
350 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
26 |
26 |
$0.00 |
| 3051F |
|
70 |
69 |
$0.00 |
| 0502F |
|
162 |
127 |
$0.00 |
| 99408 |
|
21 |
21 |
$0.00 |
| 1124F |
|
42 |
41 |
$0.00 |
| 3045F |
|
16 |
13 |
$0.00 |