| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,011 |
3,831 |
$130K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,154 |
1,128 |
$101K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
98 |
98 |
$95K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,570 |
2,552 |
$91K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,326 |
15,952 |
$83K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,043 |
988 |
$79K |
| 99223 |
Prolong inpt eval add15 m |
410 |
367 |
$76K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,459 |
1,430 |
$69K |
| 99215 |
Prolong outpt/office vis |
629 |
620 |
$61K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,551 |
719 |
$51K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,290 |
1,246 |
$44K |
| 59425 |
|
1,205 |
825 |
$43K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,252 |
456 |
$40K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
69 |
69 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
981 |
978 |
$36K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
781 |
768 |
$32K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
884 |
281 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
994 |
972 |
$30K |
| 99233 |
Prolong inpt eval add15 m |
638 |
211 |
$25K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,955 |
2,888 |
$24K |
| J3490 |
Unclassified drugs |
205 |
187 |
$24K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
41 |
40 |
$23K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
178 |
168 |
$22K |
| 99205 |
Prolong outpt/office vis |
159 |
159 |
$17K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
125 |
87 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
255 |
252 |
$15K |
| 92586 |
|
326 |
317 |
$14K |
| 99222 |
Initial hospital care, per day, moderate complexity |
100 |
92 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
285 |
260 |
$13K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
365 |
356 |
$12K |
| A4267 |
Contraceptive supply, condom, male, each |
142 |
139 |
$12K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
133 |
133 |
$12K |
| 76813 |
|
105 |
105 |
$11K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
976 |
893 |
$10K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
58 |
58 |
$10K |
| 85018 |
|
3,292 |
3,264 |
$9K |
| 92557 |
|
93 |
92 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
197 |
197 |
$9K |
| 59025 |
Fetal non-stress test |
324 |
100 |
$7K |
| E0570 |
Nebulizer, with compressor |
120 |
120 |
$6K |
| 71045 |
Radiologic examination, chest; single view |
371 |
324 |
$6K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$5K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,857 |
882 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
924 |
877 |
$5K |
| 76830 |
Ultrasound, transvaginal |
128 |
128 |
$5K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
56 |
55 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
438 |
432 |
$5K |
| 97803 |
|
131 |
130 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
82 |
80 |
$4K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
148 |
138 |
$4K |
| 59426 |
|
84 |
84 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
215 |
215 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
106 |
79 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
45 |
45 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
28 |
26 |
$2K |
| 81025 |
|
948 |
900 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,533 |
5,133 |
$2K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
13 |
12 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
214 |
134 |
$2K |
| 99053 |
|
70 |
70 |
$2K |
| 99460 |
|
44 |
43 |
$2K |
| 92551 |
|
2,297 |
2,290 |
$2K |
| 97162 |
|
18 |
18 |
$2K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,779 |
834 |
$1K |
| S9452 |
Nutrition classes, non-physician provider, per session |
64 |
64 |
$1K |
| 88307 |
|
15 |
15 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
94 |
92 |
$1K |
| 99201 |
|
14 |
14 |
$1K |
| 92134 |
|
40 |
39 |
$1K |
| 90715 |
|
61 |
61 |
$1K |
| 80053 |
Comprehensive metabolic panel |
7,033 |
5,937 |
$1K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
36 |
33 |
$1K |
| 92225 |
|
106 |
106 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
32 |
27 |
$978.68 |
| 86592 |
|
2,119 |
2,080 |
$931.57 |
| 90696 |
|
227 |
226 |
$912.20 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
104 |
104 |
$892.89 |
| 99383 |
|
12 |
12 |
$837.12 |
| 86580 |
|
174 |
172 |
$830.00 |
| 90670 |
|
1,109 |
1,086 |
$753.00 |
| 88304 |
|
33 |
33 |
$615.60 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,831 |
862 |
$551.34 |
| 82728 |
|
414 |
407 |
$538.95 |
| 81001 |
|
3,333 |
3,119 |
$538.88 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,313 |
1,900 |
$522.63 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$496.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
645 |
634 |
$474.45 |
| H2000 |
Comprehensive multidisciplinary evaluation |
190 |
190 |
$457.95 |
| 90633 |
|
826 |
816 |
$396.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$379.77 |
| 99000 |
|
810 |
780 |
$341.13 |
| 90686 |
|
84 |
84 |
$309.52 |
| A7015 |
Aerosol mask, used with dme nebulizer |
117 |
117 |
$290.87 |
| 80061 |
Lipid panel |
3,324 |
3,302 |
$257.25 |
| 92060 |
|
1,242 |
1,237 |
$255.56 |
| 90700 |
|
338 |
336 |
$253.00 |
| 99356 |
|
192 |
122 |
$240.00 |
| 90707 |
|
758 |
754 |
$235.00 |
| 90651 |
|
13 |
13 |
$204.00 |
| 90716 |
|
750 |
746 |
$180.00 |
| 81002 |
|
1,560 |
1,470 |
$149.88 |
| 86901 |
|
1,101 |
890 |
$139.42 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
313 |
311 |
$134.12 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,946 |
2,880 |
$124.48 |
| 87806 |
|
52 |
52 |
$116.06 |
| 3078F |
|
128 |
122 |
$114.10 |
| 90698 |
|
843 |
822 |
$108.33 |
| 87070 |
|
573 |
553 |
$103.75 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
25 |
24 |
$96.43 |
| 87653 |
|
15 |
15 |
$91.56 |
| 82785 |
|
264 |
263 |
$88.08 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
839 |
823 |
$81.06 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,567 |
3,529 |
$79.48 |
| 83001 |
|
77 |
77 |
$78.27 |
| 73630 |
|
16 |
14 |
$78.10 |
| 85027 |
|
4,047 |
3,336 |
$74.15 |
| 90657 |
|
41 |
41 |
$72.00 |
| 90658 |
|
100 |
100 |
$72.00 |
| 90649 |
|
122 |
122 |
$72.00 |
| 86900 |
|
1,101 |
893 |
$70.14 |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,327 |
3,263 |
$67.16 |
| 80074 |
|
649 |
589 |
$67.12 |
| 84702 |
|
407 |
324 |
$66.20 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
474 |
464 |
$63.85 |
| 87210 |
|
111 |
107 |
$60.28 |
| 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 |
123 |
110 |
$54.36 |
| 82947 |
|
271 |
262 |
$52.40 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,438 |
2,286 |
$47.97 |
| 82950 |
|
363 |
362 |
$46.48 |
| 87340 |
|
375 |
373 |
$45.60 |
| 90647 |
|
186 |
184 |
$45.00 |
| 99001 |
|
122 |
109 |
$43.79 |
| 83970 |
|
50 |
50 |
$42.93 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
112 |
111 |
$41.94 |
| 86003 |
|
313 |
310 |
$27.90 |
| 99173 |
|
1,117 |
1,110 |
$27.82 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
78 |
77 |
$27.06 |
| 90743 |
|
252 |
244 |
$27.00 |
| 90680 |
|
326 |
324 |
$27.00 |
| 36415 |
Collection of venous blood by venipuncture |
7,694 |
7,227 |
$25.32 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
101 |
100 |
$24.00 |
| 83498 |
|
232 |
213 |
$20.34 |
| 85610 |
|
1,239 |
1,004 |
$18.12 |
| 84100 |
|
380 |
182 |
$16.78 |
| 81003 |
|
827 |
741 |
$15.50 |
| 90744 |
|
171 |
169 |
$9.00 |
| 80076 |
|
890 |
606 |
$8.94 |
| 82043 |
|
492 |
490 |
$5.08 |
| 85730 |
|
941 |
793 |
$3.86 |
| 87147 |
|
256 |
250 |
$1.92 |
| 87081 |
|
515 |
499 |
$1.14 |
| 85007 |
|
878 |
582 |
$0.54 |
| 86850 |
|
792 |
716 |
$0.00 |
| 86880 |
|
42 |
30 |
$0.00 |
| 83550 |
|
355 |
350 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,548 |
1,539 |
$0.00 |
| 3074F |
|
160 |
150 |
$0.00 |
| 87040 |
|
286 |
244 |
$0.00 |
| 82746 |
|
194 |
191 |
$0.00 |
| 84484 |
|
130 |
113 |
$0.00 |
| 83735 |
|
520 |
243 |
$0.00 |
| 82550 |
|
31 |
28 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,036 |
1,027 |
$0.00 |
| 84703 |
|
582 |
553 |
$0.00 |
| 97014 |
|
1,043 |
500 |
$0.00 |
| 83615 |
|
90 |
70 |
$0.00 |
| 83021 |
|
284 |
264 |
$0.00 |
| 85379 |
|
26 |
26 |
$0.00 |
| 92226 |
|
125 |
122 |
$0.00 |
| 94760 |
|
1,101 |
1,009 |
$0.00 |
| 86803 |
|
393 |
393 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13 |
12 |
$0.00 |
| 87088 |
|
1,341 |
1,298 |
$0.00 |
| 83880 |
|
168 |
127 |
$0.00 |
| 84153 |
|
156 |
153 |
$0.00 |
| 83690 |
|
689 |
627 |
$0.00 |
| 82261 |
|
210 |
191 |
$0.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
64 |
64 |
$0.00 |
| 82378 |
|
31 |
30 |
$0.00 |
| 90688 |
|
47 |
47 |
$0.00 |
| 86762 |
|
103 |
94 |
$0.00 |
| 80081 |
|
175 |
175 |
$0.00 |
| 85652 |
|
628 |
603 |
$0.00 |
| 96161 |
|
105 |
105 |
$0.00 |
| 88141 |
|
61 |
61 |
$0.00 |
| 86140 |
|
592 |
545 |
$0.00 |
| 83789 |
|
210 |
191 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
15 |
14 |
$0.00 |
| 83605 |
|
183 |
124 |
$0.00 |
| 82607 |
|
251 |
248 |
$0.00 |
| 84436 |
|
52 |
52 |
$0.00 |
| 88142 |
|
67 |
66 |
$0.00 |
| 3008F |
|
198 |
183 |
$0.00 |
| 36416 |
|
102 |
102 |
$0.00 |
| 82962 |
|
97 |
56 |
$0.00 |
| 92567 |
|
186 |
93 |
$0.00 |
| 93000 |
|
28 |
28 |
$0.00 |
| 96127 |
|
55 |
55 |
$0.00 |
| 96151 |
|
143 |
142 |
$0.00 |
| 86780 |
|
13 |
13 |
$0.00 |
| 82784 |
|
13 |
13 |
$0.00 |
| 87077 |
|
546 |
521 |
$0.00 |
| 97750 |
|
30 |
29 |
$0.00 |
| 82951 |
|
29 |
28 |
$0.00 |
| 87390 |
|
14 |
13 |
$0.00 |
| 86376 |
|
13 |
13 |
$0.00 |
| 97018 |
|
30 |
12 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
71 |
71 |
$0.00 |
| 83986 |
|
15 |
15 |
$0.00 |
| 87205 |
|
89 |
77 |
$0.00 |
| 83002 |
|
12 |
12 |
$0.00 |
| 82120 |
|
14 |
14 |
$0.00 |
| 80047 |
|
20 |
14 |
$0.00 |
| 86225 |
|
14 |
13 |
$0.00 |
| 82952 |
|
14 |
13 |
$0.00 |
| 86160 |
|
14 |
13 |
$0.00 |
| 84480 |
|
13 |
13 |
$0.00 |
| 86706 |
|
14 |
14 |
$0.00 |
| 20610 |
|
19 |
16 |
$0.00 |
| 81000 |
|
17 |
17 |
$0.00 |
| 82274 |
|
125 |
124 |
$0.00 |
| 82948 |
|
309 |
289 |
$0.00 |
| 94150 |
|
56 |
53 |
$0.00 |
| 83540 |
|
426 |
421 |
$0.00 |
| 82776 |
|
210 |
191 |
$0.00 |
| 0502F |
|
370 |
255 |
$0.00 |
| 83516 |
|
273 |
254 |
$0.00 |
| 86038 |
|
259 |
256 |
$0.00 |
| 83655 |
|
1,207 |
1,203 |
$0.00 |
| 85014 |
|
106 |
102 |
$0.00 |
| 82248 |
|
202 |
201 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
128 |
120 |
$0.00 |
| 87186 |
|
562 |
535 |
$0.00 |
| 84481 |
|
140 |
139 |
$0.00 |
| 84439 |
|
815 |
803 |
$0.00 |
| 84156 |
|
105 |
92 |
$0.00 |
| 92015 |
Determination of refractive state |
84 |
84 |
$0.00 |
| 82570 |
|
659 |
633 |
$0.00 |
| 99051 |
|
326 |
313 |
$0.00 |
| 90713 |
|
128 |
128 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
106 |
95 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
40 |
40 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
193 |
193 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
116 |
108 |
$0.00 |
| 86431 |
|
116 |
114 |
$0.00 |
| 99401 |
|
145 |
144 |
$0.00 |
| 92081 |
|
109 |
109 |
$0.00 |
| 11721 |
|
17 |
16 |
$0.00 |
| 92588 |
|
90 |
89 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
140 |
138 |
$0.00 |
| 84550 |
|
313 |
272 |
$0.00 |
| 92579 |
|
25 |
24 |
$0.00 |
| 96152 |
|
64 |
64 |
$0.00 |
| 83525 |
|
12 |
12 |
$0.00 |
| 90681 |
|
53 |
50 |
$0.00 |
| 92568 |
|
95 |
92 |
$0.00 |
| 92133 |
|
25 |
25 |
$0.00 |
| 84403 |
|
65 |
65 |
$0.00 |
| A0425 |
Ground mileage, per statute mile |
39 |
36 |
$0.00 |
| 86923 |
|
16 |
12 |
$0.00 |
| 92083 |
|
41 |
41 |
$0.00 |
| 84146 |
|
31 |
30 |
$0.00 |
| 99152 |
|
12 |
12 |
$0.00 |
| 99188 |
|
12 |
12 |
$0.00 |
| 86703 |
|
14 |
13 |
$0.00 |
| 87075 |
|
29 |
26 |
$0.00 |
| 88312 |
|
18 |
18 |
$0.00 |