| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36,849 |
34,093 |
$2.77M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,946 |
19,836 |
$2.54M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
6,103 |
6,047 |
$762K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,479 |
7,422 |
$480K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,331 |
2,293 |
$421K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,381 |
1,380 |
$230K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
431 |
381 |
$230K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
9,050 |
9,012 |
$147K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,923 |
718 |
$141K |
| 99221 |
|
1,396 |
1,363 |
$131K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,266 |
1,260 |
$122K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,238 |
1,222 |
$97K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,064 |
1,064 |
$90K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,089 |
1,069 |
$85K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
826 |
790 |
$77K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
634 |
634 |
$76K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,793 |
1,083 |
$74K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,129 |
3,094 |
$54K |
| 71046 |
Radiologic examination, chest; 2 views |
4,430 |
4,371 |
$52K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
452 |
452 |
$48K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
5,225 |
4,818 |
$45K |
| 99460 |
|
442 |
440 |
$44K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,098 |
1,096 |
$43K |
| 70450 |
Computed tomography, head or brain; without contrast material |
950 |
933 |
$41K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
393 |
387 |
$39K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
3,743 |
3,738 |
$37K |
| 71045 |
Radiologic examination, chest; single view |
3,749 |
3,129 |
$35K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
658 |
640 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
367 |
367 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
927 |
861 |
$26K |
| 90682 |
|
345 |
345 |
$22K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
497 |
337 |
$21K |
| 94010 |
|
512 |
508 |
$21K |
| 99215 |
Prolong outpt/office vis |
133 |
130 |
$21K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
117 |
117 |
$20K |
| 99222 |
Initial hospital care, per day, moderate complexity |
209 |
208 |
$19K |
| 92552 |
|
488 |
487 |
$19K |
| 16020 |
|
227 |
140 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
131 |
131 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,006 |
1,003 |
$16K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
488 |
488 |
$15K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
53 |
25 |
$14K |
| 99223 |
Prolong inpt eval add15 m |
78 |
78 |
$14K |
| 36415 |
Collection of venous blood by venipuncture |
5,989 |
5,883 |
$13K |
| 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) |
1,506 |
1,397 |
$12K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
168 |
67 |
$12K |
| 93000 |
|
638 |
630 |
$12K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
219 |
219 |
$10K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
293 |
288 |
$9K |
| 99443 |
|
139 |
114 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
84 |
84 |
$8K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
24 |
24 |
$8K |
| 95951 |
|
24 |
14 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
53 |
$7K |
| 99462 |
|
148 |
117 |
$6K |
| 99233 |
Prolong inpt eval add15 m |
59 |
25 |
$6K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
92 |
12 |
$6K |
| 00731 |
|
26 |
26 |
$5K |
| 99497 |
|
78 |
77 |
$5K |
| 76830 |
Ultrasound, transvaginal |
98 |
96 |
$5K |
| 99072 |
|
5,495 |
5,201 |
$5K |
| 76813 |
|
72 |
72 |
$5K |
| 88312 |
|
112 |
112 |
$4K |
| 95012 |
|
190 |
190 |
$4K |
| 76642 |
|
107 |
107 |
$4K |
| 90677 |
|
110 |
110 |
$4K |
| 88304 |
|
250 |
244 |
$3K |
| 77065 |
Tomosynthesis, mammo |
73 |
73 |
$3K |
| 99457 |
|
76 |
75 |
$3K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
49 |
44 |
$3K |
| 94664 |
|
139 |
138 |
$3K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
34 |
34 |
$3K |
| 92551 |
|
189 |
189 |
$3K |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$3K |
| 3079F |
|
7,030 |
6,845 |
$2K |
| 86077 |
|
43 |
38 |
$2K |
| 77061 |
|
13 |
13 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
52 |
51 |
$2K |
| 95117 |
|
169 |
67 |
$2K |
| 99000 |
|
444 |
439 |
$2K |
| 99386 |
|
15 |
15 |
$2K |
| 3074F |
|
15,749 |
15,179 |
$2K |
| 99458 |
|
24 |
24 |
$2K |
| 90673 |
|
18 |
18 |
$1K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
12 |
12 |
$1K |
| 81002 |
|
410 |
339 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
110 |
110 |
$1K |
| 73630 |
|
109 |
103 |
$1K |
| 99385 |
|
13 |
13 |
$1K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
27 |
26 |
$941.40 |
| 51701 |
|
26 |
25 |
$777.72 |
| 73130 |
|
76 |
72 |
$757.21 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
84 |
83 |
$580.06 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
13 |
$573.41 |
| 59025 |
Fetal non-stress test |
14 |
13 |
$504.11 |
| 3078F |
|
7,220 |
6,963 |
$500.03 |
| 90688 |
|
30 |
30 |
$486.26 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
25 |
14 |
$430.34 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$361.91 |
| 73610 |
|
41 |
39 |
$359.69 |
| 99304 |
|
14 |
14 |
$347.41 |
| 3075F |
|
475 |
465 |
$320.00 |
| 93018 |
|
16 |
16 |
$256.22 |
| 90670 |
|
271 |
271 |
$232.05 |
| 90698 |
|
291 |
291 |
$178.50 |
| 90686 |
|
347 |
343 |
$175.28 |
| 73562 |
|
14 |
13 |
$138.87 |
| 99053 |
|
1,565 |
1,545 |
$136.72 |
| 90744 |
|
70 |
70 |
$89.25 |
| 94760 |
|
12 |
12 |
$14.75 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,968 |
3,965 |
$1.58 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
22,334 |
21,393 |
$0.15 |
| G9665 |
Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy |
173 |
173 |
$0.09 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
2,974 |
2,974 |
$0.07 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
12 |
12 |
$0.04 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
2,912 |
2,811 |
$0.01 |
| 3008F |
|
2,197 |
2,195 |
$0.00 |
| 99429 |
|
585 |
472 |
$0.00 |
| 1036F |
|
1,228 |
1,228 |
$0.00 |
| G2181 |
Bmi not documented due to medical reason or patient refusal of height or weight measurement |
391 |
328 |
$0.00 |
| 1034F |
|
170 |
162 |
$0.00 |
| 1126F |
|
387 |
387 |
$0.00 |
| 90656 |
|
17 |
17 |
$0.00 |
| 1125F |
|
13 |
13 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
670 |
670 |
$0.00 |
| 1159F |
|
443 |
443 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
170 |
170 |
$0.00 |
| 3016F |
|
177 |
177 |
$0.00 |
| G9509 |
Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5 |
195 |
195 |
$0.00 |
| 3077F |
|
28 |
28 |
$0.00 |
| 1160F |
|
92 |
92 |
$0.00 |
| 1033F |
|
215 |
215 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
16 |
16 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
13 |
12 |
$0.00 |
| 1090F |
|
29 |
28 |
$0.00 |