| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79,343 |
66,039 |
$3.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37,231 |
32,715 |
$2.01M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
11,901 |
10,668 |
$772K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
9,399 |
9,078 |
$620K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,988 |
5,736 |
$396K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16,458 |
15,836 |
$352K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,760 |
2,562 |
$295K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,845 |
3,644 |
$255K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23,192 |
22,105 |
$229K |
| W0037 |
|
26,870 |
26,870 |
$190K |
| 99460 |
|
2,427 |
2,302 |
$188K |
| 99215 |
Prolong outpt/office vis |
2,279 |
2,069 |
$175K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
2,741 |
2,580 |
$152K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
5,439 |
4,807 |
$150K |
| 54150 |
|
1,127 |
1,027 |
$140K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,648 |
1,496 |
$106K |
| 99222 |
Initial hospital care, per day, moderate complexity |
1,078 |
955 |
$97K |
| 0240U |
|
831 |
788 |
$86K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,290 |
1,161 |
$79K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
2,604 |
2,254 |
$72K |
| 71046 |
Radiologic examination, chest; 2 views |
3,147 |
2,847 |
$62K |
| 90473 |
|
5,983 |
5,804 |
$58K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,258 |
849 |
$58K |
| 99462 |
|
1,544 |
1,202 |
$51K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
1,486 |
1,347 |
$48K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,051 |
1,002 |
$46K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,893 |
1,716 |
$46K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
626 |
585 |
$44K |
| 36415 |
Collection of venous blood by venipuncture |
9,246 |
7,874 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
411 |
379 |
$41K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
956 |
891 |
$37K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
508 |
418 |
$36K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,758 |
3,147 |
$34K |
| 90651 |
|
3,260 |
3,118 |
$27K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
607 |
552 |
$25K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,975 |
3,453 |
$24K |
| 99223 |
Prolong inpt eval add15 m |
200 |
171 |
$23K |
| 90686 |
|
10,907 |
10,452 |
$23K |
| 91322 |
|
226 |
155 |
$22K |
| 90715 |
|
2,334 |
2,232 |
$20K |
| 17110 |
|
235 |
219 |
$18K |
| 0001A |
|
559 |
472 |
$17K |
| 99383 |
|
184 |
174 |
$17K |
| 0002A |
|
504 |
453 |
$17K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,270 |
1,152 |
$16K |
| 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 |
249 |
231 |
$15K |
| 74018 |
|
783 |
693 |
$14K |
| 80050 |
General health panel |
532 |
461 |
$14K |
| 90480 |
|
553 |
530 |
$14K |
| 80053 |
Comprehensive metabolic panel |
1,580 |
1,424 |
$13K |
| 87631 |
|
99 |
83 |
$13K |
| 80061 |
Lipid panel |
1,157 |
1,056 |
$12K |
| 0071A |
|
276 |
265 |
$10K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,263 |
1,159 |
$10K |
| 90837 |
Psychotherapy, 53 minutes with patient |
92 |
50 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
699 |
569 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
386 |
259 |
$8K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
148 |
135 |
$8K |
| 99384 |
|
99 |
92 |
$8K |
| 0072A |
|
196 |
191 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
124 |
118 |
$6K |
| 81001 |
|
2,407 |
2,063 |
$6K |
| 90656 |
|
1,126 |
1,091 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
587 |
516 |
$5K |
| 84439 |
|
780 |
717 |
$5K |
| 87634 |
|
92 |
81 |
$5K |
| 0124A |
|
184 |
174 |
$5K |
| 90670 |
|
6,879 |
6,648 |
$5K |
| 0081A |
|
167 |
151 |
$5K |
| 90677 |
|
56 |
55 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
642 |
577 |
$4K |
| 90671 |
|
2,103 |
2,027 |
$4K |
| 81025 |
|
593 |
518 |
$4K |
| 85027 |
|
789 |
693 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
136 |
123 |
$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) |
5,130 |
4,556 |
$4K |
| 87510 |
|
247 |
203 |
$3K |
| 87660 |
|
249 |
202 |
$3K |
| 87480 |
|
244 |
202 |
$3K |
| 74019 |
|
183 |
162 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
465 |
423 |
$3K |
| 90620 |
|
299 |
290 |
$3K |
| 90734 |
|
2,286 |
2,189 |
$3K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
536 |
504 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
453 |
351 |
$3K |
| 90716 |
|
2,336 |
2,248 |
$2K |
| 90707 |
|
2,319 |
2,230 |
$2K |
| 90750 |
|
12 |
12 |
$2K |
| 99188 |
|
78 |
74 |
$2K |
| 0054A |
|
87 |
64 |
$2K |
| 99382 |
|
28 |
26 |
$2K |
| 0082A |
|
47 |
47 |
$2K |
| 73630 |
|
87 |
77 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
20 |
15 |
$1K |
| 96381 |
|
214 |
109 |
$1K |
| 83550 |
|
188 |
170 |
$1K |
| 73610 |
|
75 |
65 |
$1K |
| 99307 |
|
58 |
51 |
$1K |
| 0004A |
|
59 |
40 |
$1K |
| 83540 |
|
206 |
188 |
$1K |
| 87807 |
|
73 |
65 |
$1K |
| 0074A |
|
26 |
26 |
$1K |
| 99221 |
|
12 |
12 |
$987.67 |
| 87210 |
|
225 |
199 |
$985.77 |
| 99417 |
Prolong home eval add 15m |
31 |
30 |
$852.06 |
| 0154A |
|
24 |
21 |
$704.36 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
19 |
16 |
$675.29 |
| 36416 |
|
1,518 |
1,284 |
$635.34 |
| 0051A |
|
25 |
18 |
$595.05 |
| 0003A |
|
16 |
15 |
$555.38 |
| 0052A |
|
16 |
15 |
$555.38 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
16 |
14 |
$529.95 |
| 0053A |
|
13 |
13 |
$468.26 |
| 91321 |
|
217 |
213 |
$437.76 |
| 99442 |
|
42 |
38 |
$406.59 |
| 69209 |
|
32 |
28 |
$386.98 |
| 85018 |
|
126 |
114 |
$232.26 |
| 90633 |
|
4,944 |
4,766 |
$167.20 |
| 90710 |
|
2,108 |
2,023 |
$63.70 |
| 85651 |
|
12 |
12 |
$51.24 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
35 |
25 |
$49.68 |
| 96161 |
|
12 |
12 |
$43.50 |
| 90685 |
|
168 |
168 |
$23.64 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
50 |
44 |
$4.85 |
| 90696 |
|
1,859 |
1,778 |
$0.31 |
| 90461 |
|
71 |
70 |
$0.00 |
| 90672 |
|
15 |
15 |
$0.00 |
| 90700 |
|
2,277 |
2,197 |
$0.00 |
| 90648 |
|
7,151 |
6,916 |
$0.00 |
| 90713 |
|
19 |
18 |
$0.00 |
| 91300 |
|
1,097 |
858 |
$0.00 |
| 90661 |
|
81 |
73 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
114 |
114 |
$0.00 |
| 90687 |
|
17 |
17 |
$0.00 |
| 90380 |
|
55 |
35 |
$0.00 |
| 90723 |
|
5,214 |
5,047 |
$0.00 |
| 90680 |
|
5,838 |
5,647 |
$0.00 |
| 90697 |
|
1,563 |
1,515 |
$0.00 |
| 91307 |
|
447 |
414 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
221 |
215 |
$0.00 |
| 91305 |
|
254 |
213 |
$0.00 |
| 90381 |
|
134 |
98 |
$0.00 |