| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,102 |
4,196 |
$186K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,652 |
2,198 |
$139K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
3,109 |
69 |
$41K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
735 |
495 |
$32K |
| W0037 |
|
1,888 |
1,888 |
$29K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
755 |
592 |
$23K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,361 |
120 |
$17K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,652 |
685 |
$17K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
350 |
164 |
$16K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
805 |
269 |
$12K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
246 |
246 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
1,942 |
1,598 |
$9K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
206 |
56 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
672 |
645 |
$7K |
| A9270 |
Non-covered item or service |
281 |
28 |
$6K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
69 |
54 |
$5K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
93 |
93 |
$5K |
| 99223 |
Prolong inpt eval add15 m |
127 |
123 |
$5K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
314 |
119 |
$5K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
226 |
203 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
218 |
145 |
$4K |
| 99215 |
Prolong outpt/office vis |
92 |
78 |
$4K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
81 |
67 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
192 |
99 |
$4K |
| 90961 |
|
72 |
72 |
$3K |
| A0425 |
Ground mileage, per statute mile |
135 |
123 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
191 |
128 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
101 |
70 |
$3K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
29 |
26 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
120 |
107 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
81 |
77 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
135 |
128 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
160 |
105 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
69 |
66 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
75 |
74 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
265 |
55 |
$1K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
149 |
90 |
$1K |
| E0601 |
Continuous positive airway pressure (cpap) device |
68 |
68 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
46 |
42 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
160 |
121 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
50 |
41 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
356 |
274 |
$1K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
117 |
93 |
$1K |
| 99442 |
|
91 |
89 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
71 |
66 |
$990.49 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
71 |
67 |
$905.43 |
| 71046 |
Radiologic examination, chest; 2 views |
206 |
139 |
$891.46 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
29 |
29 |
$840.77 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
39 |
15 |
$818.82 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
106 |
52 |
$757.86 |
| A7031 |
Face mask interface, replacement for full face mask, each |
29 |
29 |
$750.01 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
46 |
28 |
$662.66 |
| 99307 |
|
50 |
48 |
$655.02 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
63 |
40 |
$583.16 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
57 |
44 |
$554.20 |
| 90686 |
|
71 |
71 |
$534.12 |
| 99443 |
|
66 |
65 |
$495.70 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
31 |
26 |
$491.56 |
| E1392 |
Portable oxygen concentrator, rental |
61 |
61 |
$487.27 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
46 |
46 |
$447.41 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
32 |
32 |
$418.61 |
| 11721 |
|
39 |
30 |
$399.55 |
| A7030 |
Full face mask used with positive airway pressure device, each |
14 |
14 |
$372.22 |
| 90656 |
|
26 |
26 |
$338.00 |
| 73030 |
|
31 |
26 |
$328.84 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
47 |
46 |
$277.20 |
| 73502 |
|
25 |
19 |
$267.25 |
| Q3014 |
Telehealth originating site facility fee |
83 |
44 |
$229.48 |
| 20610 |
|
17 |
13 |
$191.47 |
| 98940 |
|
32 |
28 |
$185.34 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
52 |
52 |
$182.61 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
33 |
33 |
$162.54 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
28 |
25 |
$155.12 |
| A7035 |
Headgear used with positive airway pressure device |
27 |
27 |
$139.56 |
| 92134 |
|
16 |
14 |
$130.12 |
| 74018 |
|
26 |
20 |
$129.02 |
| E0570 |
Nebulizer, with compressor |
52 |
52 |
$94.13 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
22 |
22 |
$92.05 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
13 |
13 |
$86.12 |
| 99441 |
|
12 |
12 |
$52.25 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
12 |
12 |
$31.18 |
| 73630 |
|
12 |
12 |
$22.47 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$20.48 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
15 |
14 |
$0.00 |