| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3490 |
Unclassified drugs |
2,974 |
2,495 |
$237K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26,279 |
24,043 |
$177K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,445 |
8,781 |
$87K |
| 90715 |
|
2,466 |
2,398 |
$79K |
| 90686 |
|
4,684 |
4,547 |
$76K |
| 90746 |
|
749 |
745 |
$50K |
| 90732 |
|
314 |
312 |
$24K |
| 90688 |
|
1,276 |
1,273 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
892 |
811 |
$9K |
| 90674 |
|
287 |
285 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,625 |
2,129 |
$8K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,940 |
2,825 |
$8K |
| 99490 |
Ccm add 20min |
284 |
283 |
$8K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,488 |
1,447 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
302 |
242 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
504 |
499 |
$6K |
| 59425 |
|
1,253 |
905 |
$6K |
| A4267 |
Contraceptive supply, condom, male, each |
310 |
221 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,602 |
3,324 |
$6K |
| 92551 |
|
3,851 |
2,913 |
$6K |
| 92552 |
|
2,258 |
2,224 |
$6K |
| 90739 |
|
39 |
39 |
$5K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,839 |
1,120 |
$5K |
| 99215 |
Prolong outpt/office vis |
1,215 |
1,138 |
$5K |
| 90670 |
|
1,846 |
1,536 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,145 |
1,733 |
$4K |
| 90658 |
|
295 |
295 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,181 |
1,034 |
$4K |
| 69210 |
|
64 |
64 |
$4K |
| 90677 |
|
12 |
12 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,794 |
1,769 |
$3K |
| 90662 |
|
57 |
57 |
$3K |
| J2785 |
Injection, regadenoson, 0.1 mg |
14 |
14 |
$3K |
| 95117 |
|
701 |
292 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
37 |
28 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,025 |
953 |
$2K |
| 99173 |
|
3,701 |
3,517 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
257 |
248 |
$1K |
| 97803 |
|
2,448 |
1,523 |
$1K |
| 83013 |
|
206 |
206 |
$1K |
| 99401 |
|
5,316 |
3,443 |
$1K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
290 |
245 |
$1K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
29 |
29 |
$990.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
200 |
198 |
$984.24 |
| 90656 |
|
47 |
47 |
$854.30 |
| D1206 |
Topical application of fluoride varnish |
733 |
375 |
$815.76 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
438 |
402 |
$767.40 |
| 90682 |
|
12 |
12 |
$725.64 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
117 |
117 |
$717.60 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,622 |
1,296 |
$714.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
670 |
435 |
$660.31 |
| G9920 |
Screening performed and negative |
13 |
13 |
$657.14 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$578.03 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,022 |
948 |
$555.68 |
| 99201 |
|
17 |
12 |
$545.28 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
778 |
776 |
$536.86 |
| 90756 |
|
27 |
27 |
$505.53 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,934 |
2,818 |
$466.22 |
| 94760 |
|
70 |
64 |
$328.32 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
162 |
143 |
$283.88 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14 |
14 |
$275.50 |
| 36415 |
Collection of venous blood by venipuncture |
15,225 |
14,283 |
$269.43 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
51 |
51 |
$262.32 |
| H2000 |
Comprehensive multidisciplinary evaluation |
165 |
163 |
$235.17 |
| 71046 |
Radiologic examination, chest; 2 views |
153 |
140 |
$233.50 |
| 97802 |
|
2,981 |
2,106 |
$226.52 |
| 86592 |
|
1,029 |
1,019 |
$225.60 |
| 59426 |
|
95 |
74 |
$221.51 |
| 59430 |
|
14 |
14 |
$219.40 |
| 3074F |
|
767 |
714 |
$202.35 |
| 96127 |
|
1,522 |
1,365 |
$201.96 |
| 83690 |
|
117 |
116 |
$200.34 |
| 80061 |
Lipid panel |
7,796 |
7,605 |
$199.37 |
| 85018 |
|
4,677 |
3,503 |
$190.98 |
| 90633 |
|
860 |
697 |
$164.80 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15 |
15 |
$150.00 |
| 86038 |
|
356 |
349 |
$138.90 |
| 81025 |
|
459 |
440 |
$125.23 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
849 |
841 |
$122.44 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$115.58 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,505 |
4,272 |
$113.48 |
| 87088 |
|
921 |
884 |
$109.66 |
| 90655 |
|
97 |
97 |
$101.43 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,890 |
5,823 |
$99.15 |
| 87806 |
|
107 |
95 |
$95.79 |
| 96151 |
|
591 |
438 |
$95.29 |
| 93000 |
|
68 |
66 |
$92.25 |
| 90649 |
|
31 |
31 |
$90.64 |
| 3078F |
|
764 |
706 |
$74.32 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,264 |
1,201 |
$73.93 |
| 88142 |
|
587 |
584 |
$71.67 |
| 82947 |
|
119 |
115 |
$70.18 |
| 81001 |
|
2,426 |
2,358 |
$66.78 |
| 82728 |
|
559 |
552 |
$66.78 |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,756 |
2,707 |
$66.78 |
| 87340 |
|
740 |
735 |
$66.78 |
| 82746 |
|
458 |
457 |
$66.78 |
| 97014 |
|
21 |
13 |
$66.72 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
43 |
40 |
$60.63 |
| 83655 |
|
648 |
644 |
$54.75 |
| 92567 |
|
29 |
29 |
$51.08 |
| 90744 |
|
438 |
383 |
$41.20 |
| J7050 |
Infusion, normal saline solution, 250 cc |
54 |
39 |
$38.13 |
| 90700 |
|
822 |
712 |
$37.08 |
| 97750 |
|
15 |
14 |
$35.89 |
| S4993 |
Contraceptive pills for birth control |
25 |
12 |
$31.08 |
| 2010F |
|
446 |
395 |
$30.32 |
| 90698 |
|
212 |
212 |
$28.84 |
| 80053 |
Comprehensive metabolic panel |
5,619 |
5,346 |
$13.97 |
| 84439 |
|
1,220 |
1,207 |
$5.33 |
| 86140 |
|
806 |
800 |
$4.63 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
94 |
94 |
$2.14 |
| 87046 |
|
16 |
16 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,076 |
2,066 |
$0.00 |
| 86580 |
|
2,856 |
2,328 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,267 |
3,595 |
$0.00 |
| 90680 |
|
735 |
605 |
$0.00 |
| 90651 |
|
597 |
478 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
117 |
111 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
4,740 |
2,976 |
$0.00 |
| 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 |
681 |
635 |
$0.00 |
| 86706 |
|
298 |
291 |
$0.00 |
| 3008F |
|
535 |
423 |
$0.00 |
| 82043 |
|
968 |
958 |
$0.00 |
| 83735 |
|
179 |
136 |
$0.00 |
| 84436 |
|
230 |
229 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
205 |
181 |
$0.00 |
| 86317 |
|
421 |
420 |
$0.00 |
| 83021 |
|
171 |
170 |
$0.00 |
| 90696 |
|
136 |
93 |
$0.00 |
| 20610 |
|
19 |
13 |
$0.00 |
| 85027 |
|
1,506 |
1,483 |
$0.00 |
| 87430 |
|
169 |
168 |
$0.00 |
| 83550 |
|
414 |
410 |
$0.00 |
| 82550 |
|
99 |
83 |
$0.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
107 |
37 |
$0.00 |
| 99383 |
|
223 |
158 |
$0.00 |
| 86704 |
|
601 |
597 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,261 |
1,222 |
$0.00 |
| 87077 |
|
238 |
233 |
$0.00 |
| 3075F |
|
21 |
21 |
$0.00 |
| 82105 |
|
36 |
34 |
$0.00 |
| 90716 |
|
449 |
416 |
$0.00 |
| 81005 |
|
1,431 |
1,414 |
$0.00 |
| 81000 |
|
1,912 |
1,183 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,045 |
1,038 |
$0.00 |
| 96111 |
|
128 |
44 |
$0.00 |
| 86803 |
|
934 |
927 |
$0.00 |
| 96150 |
|
1,307 |
1,161 |
$0.00 |
| 84153 |
|
369 |
363 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
588 |
564 |
$0.00 |
| 80050 |
General health panel |
2,316 |
2,300 |
$0.00 |
| 82607 |
|
754 |
752 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
4,529 |
3,048 |
$0.00 |
| 80069 |
|
201 |
191 |
$0.00 |
| 86695 |
|
80 |
79 |
$0.00 |
| 87070 |
|
265 |
260 |
$0.00 |
| 90723 |
|
708 |
548 |
$0.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
80 |
72 |
$0.00 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
423 |
418 |
$0.00 |
| 87081 |
|
169 |
168 |
$0.00 |
| 3079F |
|
108 |
106 |
$0.00 |
| 87147 |
|
84 |
81 |
$0.00 |
| 87110 |
|
135 |
78 |
$0.00 |
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
347 |
326 |
$0.00 |
| 85652 |
|
626 |
613 |
$0.00 |
| 99000 |
|
104 |
95 |
$0.00 |
| 82150 |
|
60 |
60 |
$0.00 |
| 82950 |
|
129 |
129 |
$0.00 |
| 83014 |
|
78 |
78 |
$0.00 |
| 90647 |
|
350 |
328 |
$0.00 |
| 99384 |
|
20 |
14 |
$0.00 |
| 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 |
95 |
76 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
13 |
$0.00 |
| 2000F |
|
189 |
184 |
$0.00 |
| 86762 |
|
45 |
45 |
$0.00 |
| 82951 |
|
73 |
73 |
$0.00 |
| 85730 |
|
210 |
207 |
$0.00 |
| 2001F |
|
189 |
184 |
$0.00 |
| 83001 |
|
108 |
106 |
$0.00 |
| R0070 |
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen |
19 |
18 |
$0.00 |
| 86376 |
|
43 |
43 |
$0.00 |
| 84479 |
|
109 |
109 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
129 |
120 |
$0.00 |
| 80081 |
|
184 |
182 |
$0.00 |
| 82784 |
|
56 |
51 |
$0.00 |
| 83002 |
|
73 |
71 |
$0.00 |
| 97124 |
|
22 |
13 |
$0.00 |
| 88141 |
|
42 |
41 |
$0.00 |
| 99058 |
|
29 |
26 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
29 |
25 |
$0.00 |
| Q0092 |
Set-up portable x-ray equipment |
20 |
19 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
28 |
28 |
$0.00 |
| 84402 |
|
16 |
16 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
33 |
13 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
16 |
15 |
$0.00 |
| 0072A |
|
16 |
16 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
50 |
50 |
$0.00 |
| 87209 |
|
31 |
29 |
$0.00 |
| 86696 |
|
85 |
84 |
$0.00 |
| 90707 |
|
480 |
426 |
$0.00 |
| 92081 |
|
1,968 |
1,261 |
$0.00 |
| 90685 |
|
230 |
223 |
$0.00 |
| 90734 |
|
467 |
395 |
$0.00 |
| 87799 |
|
477 |
432 |
$0.00 |
| 87186 |
|
264 |
258 |
$0.00 |
| 1159F |
|
488 |
460 |
$0.00 |
| 90648 |
|
1,050 |
778 |
$0.00 |
| 90710 |
|
149 |
108 |
$0.00 |
| 99051 |
|
990 |
967 |
$0.00 |
| 85610 |
|
583 |
460 |
$0.00 |
| 90713 |
|
648 |
526 |
$0.00 |
| 83525 |
|
689 |
674 |
$0.00 |
| 84460 |
|
551 |
542 |
$0.00 |
| 84550 |
|
459 |
452 |
$0.00 |
| 86735 |
|
29 |
29 |
$0.00 |
| 86480 |
|
213 |
211 |
$0.00 |
| 86709 |
|
176 |
174 |
$0.00 |
| 82570 |
|
1,053 |
1,011 |
$0.00 |
| 1160F |
|
88 |
85 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
72 |
64 |
$0.00 |
| 82274 |
|
460 |
456 |
$0.00 |
| 86708 |
|
586 |
582 |
$0.00 |
| 85014 |
|
1,300 |
1,299 |
$0.00 |
| 83540 |
|
520 |
512 |
$0.00 |
| 84450 |
|
181 |
172 |
$0.00 |
| 99188 |
|
300 |
251 |
$0.00 |
| 99001 |
|
47 |
42 |
$0.00 |
| 96160 |
|
237 |
228 |
$0.00 |
| 84702 |
|
80 |
69 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
417 |
232 |
$0.00 |
| 83970 |
|
44 |
42 |
$0.00 |
| 87338 |
|
82 |
81 |
$0.00 |
| 96152 |
|
28 |
28 |
$0.00 |
| 92083 |
|
37 |
37 |
$0.00 |
| 82465 |
|
24 |
24 |
$0.00 |
| 86431 |
|
221 |
218 |
$0.00 |
| 82652 |
|
107 |
106 |
$0.00 |
| 90621 |
|
229 |
229 |
$0.00 |
| 87512 |
|
428 |
415 |
$0.00 |
| 81003 |
|
174 |
165 |
$0.00 |
| 86787 |
|
65 |
65 |
$0.00 |
| 84403 |
|
123 |
123 |
$0.00 |
| 83516 |
|
66 |
66 |
$0.00 |
| 81002 |
|
882 |
763 |
$0.00 |
| 86200 |
|
39 |
39 |
$0.00 |
| 86003 |
|
266 |
258 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$0.00 |
| 84146 |
|
74 |
73 |
$0.00 |
| 84481 |
|
89 |
86 |
$0.00 |
| 82977 |
|
44 |
41 |
$0.00 |
| 80074 |
|
163 |
163 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
235 |
231 |
$0.00 |
| 80076 |
|
150 |
148 |
$0.00 |
| 82785 |
|
199 |
197 |
$0.00 |
| 84100 |
|
15 |
15 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
12 |
12 |
$0.00 |
| 92133 |
|
27 |
27 |
$0.00 |
| 92015 |
Determination of refractive state |
12 |
12 |
$0.00 |
| 82565 |
|
63 |
61 |
$0.00 |
| 86765 |
|
29 |
29 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
67 |
67 |
$0.00 |
| 90461 |
|
42 |
39 |
$0.00 |
| 99382 |
|
83 |
59 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
21 |
13 |
$0.00 |
| 87045 |
|
16 |
16 |
$0.00 |
| 82248 |
|
151 |
144 |
$0.00 |
| 86235 |
|
12 |
12 |
$0.00 |
| 87427 |
|
16 |
16 |
$0.00 |
| 87177 |
|
31 |
29 |
$0.00 |
| 92020 |
|
12 |
12 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
14 |
13 |
$0.00 |
| 82247 |
|
17 |
15 |
$0.00 |