| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,408 |
13,255 |
$945K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,335 |
17,003 |
$905K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
12,999 |
12,732 |
$636K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,307 |
5,671 |
$390K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,061 |
4,992 |
$364K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,416 |
2,376 |
$171K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12,755 |
12,357 |
$145K |
| X5622 |
|
4,336 |
4,187 |
$131K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
8,039 |
7,830 |
$124K |
| 36415 |
Collection of venous blood by venipuncture |
18,773 |
17,063 |
$63K |
| 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 |
632 |
625 |
$51K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,051 |
6,694 |
$49K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
535 |
522 |
$40K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,496 |
1,459 |
$38K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
483 |
475 |
$36K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,653 |
2,585 |
$35K |
| 80061 |
Lipid panel |
2,860 |
2,804 |
$33K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
338 |
336 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
971 |
948 |
$30K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
961 |
937 |
$29K |
| 92551 |
|
5,815 |
5,715 |
$29K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
392 |
385 |
$29K |
| 85027 |
|
5,045 |
4,854 |
$28K |
| 80053 |
Comprehensive metabolic panel |
3,109 |
3,003 |
$27K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
579 |
423 |
$24K |
| 96127 |
|
6,415 |
6,245 |
$23K |
| 99188 |
|
6,146 |
6,067 |
$22K |
| 99215 |
Prolong outpt/office vis |
219 |
211 |
$21K |
| 80050 |
General health panel |
423 |
418 |
$19K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,895 |
1,859 |
$15K |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
565 |
560 |
$15K |
| 90715 |
|
921 |
895 |
$14K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
56 |
56 |
$14K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
554 |
546 |
$12K |
| 86780 |
|
1,023 |
996 |
$12K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
69 |
39 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
355 |
331 |
$11K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
536 |
528 |
$11K |
| 90686 |
|
3,961 |
3,863 |
$11K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,960 |
1,809 |
$11K |
| 87653 |
|
311 |
302 |
$11K |
| 99000 |
|
732 |
710 |
$9K |
| 59426 |
|
15 |
15 |
$8K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
227 |
225 |
$8K |
| 99173 |
|
6,552 |
6,446 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
920 |
888 |
$6K |
| 86803 |
|
391 |
387 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
175 |
169 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
639 |
615 |
$5K |
| 82728 |
|
401 |
388 |
$5K |
| 90670 |
|
3,550 |
3,447 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
587 |
564 |
$4K |
| 90474 |
|
666 |
653 |
$4K |
| 83655 |
|
378 |
359 |
$4K |
| 99442 |
|
165 |
100 |
$4K |
| 90473 |
|
322 |
321 |
$4K |
| 36416 |
|
1,346 |
1,167 |
$3K |
| 87210 |
|
731 |
696 |
$3K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
68 |
60 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
25 |
$3K |
| 81001 |
|
1,133 |
1,088 |
$3K |
| 96161 |
|
1,681 |
1,611 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
76 |
74 |
$2K |
| 85018 |
|
1,031 |
1,019 |
$2K |
| 99443 |
|
57 |
32 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
46 |
46 |
$2K |
| 90651 |
|
155 |
153 |
$2K |
| 87340 |
|
157 |
154 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
25 |
25 |
$2K |
| 99460 |
|
25 |
25 |
$2K |
| 99441 |
|
112 |
66 |
$2K |
| 87081 |
|
418 |
406 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
147 |
146 |
$1K |
| 82950 |
|
299 |
289 |
$1K |
| 76801 |
|
14 |
14 |
$1K |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
151 |
144 |
$1K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$1K |
| 0072A |
|
28 |
27 |
$1K |
| 90682 |
|
26 |
24 |
$1K |
| 90461 |
|
31 |
31 |
$889.61 |
| 86850 |
|
93 |
90 |
$857.49 |
| 84439 |
|
112 |
109 |
$804.94 |
| 90707 |
|
843 |
830 |
$778.54 |
| 90716 |
|
577 |
561 |
$708.22 |
| 0071A |
|
16 |
16 |
$640.16 |
| 84703 |
|
134 |
130 |
$605.21 |
| 86762 |
|
39 |
38 |
$545.81 |
| 90734 |
|
177 |
170 |
$480.42 |
| 90698 |
|
2,185 |
2,114 |
$410.84 |
| 90680 |
|
844 |
828 |
$364.38 |
| 93000 |
|
38 |
38 |
$351.42 |
| 82043 |
|
54 |
53 |
$324.83 |
| 83550 |
|
39 |
38 |
$308.38 |
| 59025 |
Fetal non-stress test |
15 |
12 |
$279.12 |
| 82607 |
|
15 |
14 |
$222.82 |
| 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) |
114 |
110 |
$194.26 |
| 90656 |
|
215 |
215 |
$142.68 |
| 71046 |
Radiologic examination, chest; 2 views |
13 |
12 |
$140.70 |
| 85652 |
|
58 |
57 |
$124.36 |
| 81003 |
|
46 |
44 |
$99.86 |
| 83540 |
|
16 |
15 |
$90.88 |
| 87186 |
|
13 |
12 |
$86.03 |
| 90744 |
|
1,341 |
1,296 |
$85.70 |
| 86140 |
|
16 |
16 |
$83.12 |
| 86900 |
|
24 |
24 |
$69.66 |
| 86901 |
|
24 |
24 |
$69.52 |
| 90633 |
|
1,356 |
1,328 |
$68.64 |
| 85610 |
|
15 |
13 |
$57.54 |
| 82952 |
|
37 |
33 |
$24.84 |
| 90685 |
|
273 |
267 |
$20.00 |
| 99421 |
|
26 |
26 |
$10.10 |
| 90677 |
|
283 |
276 |
$0.00 |
| 90696 |
|
138 |
137 |
$0.00 |
| G0180 |
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
13 |
12 |
$0.00 |
| 90697 |
|
121 |
118 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
27 |
27 |
$0.00 |
| 90681 |
|
623 |
590 |
$0.00 |
| 90648 |
|
110 |
109 |
$0.00 |
| 90700 |
|
92 |
90 |
$0.00 |