| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
106,722 |
89,117 |
$8.21M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
108,617 |
94,011 |
$5.73M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,985 |
12,910 |
$1.74M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
11,286 |
11,228 |
$1.02M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
16,869 |
16,754 |
$851K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
12,909 |
11,547 |
$791K |
| D1110 |
Prophylaxis - adult |
14,004 |
10,273 |
$630K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13,241 |
11,745 |
$525K |
| D0120 |
Periodic oral evaluation - established patient |
19,638 |
11,586 |
$459K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,195 |
4,664 |
$386K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,615 |
10,274 |
$379K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,830 |
4,355 |
$356K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,690 |
4,124 |
$338K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
3,778 |
3,699 |
$322K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,324 |
2,270 |
$294K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
3,394 |
3,392 |
$284K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,012 |
2,777 |
$248K |
| 76801 |
|
4,860 |
4,764 |
$210K |
| 76830 |
Ultrasound, transvaginal |
4,839 |
4,564 |
$178K |
| D0274 |
Bitewings - four radiographic images |
6,782 |
4,682 |
$172K |
| 64483 |
|
1,361 |
1,354 |
$158K |
| 99460 |
|
2,059 |
2,057 |
$157K |
| 59025 |
Fetal non-stress test |
5,618 |
3,360 |
$150K |
| 99215 |
Prolong outpt/office vis |
1,312 |
1,212 |
$145K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,003 |
1,440 |
$144K |
| 76813 |
|
2,687 |
2,685 |
$142K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
2,923 |
834 |
$140K |
| 99205 |
Prolong outpt/office vis |
553 |
553 |
$90K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,492 |
686 |
$90K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,109 |
1,109 |
$82K |
| D0140 |
Limited oral evaluation - problem focused |
3,746 |
2,537 |
$81K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,842 |
1,809 |
$79K |
| 71046 |
Radiologic examination, chest; 2 views |
8,431 |
8,351 |
$73K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,078 |
1,015 |
$71K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,550 |
3,543 |
$66K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
899 |
892 |
$62K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,688 |
1,627 |
$53K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,891 |
1,649 |
$49K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
497 |
483 |
$46K |
| 99222 |
Initial hospital care, per day, moderate complexity |
497 |
489 |
$46K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,456 |
445 |
$44K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,289 |
2,266 |
$42K |
| D0330 |
Panoramic radiographic image |
1,026 |
741 |
$35K |
| 71045 |
Radiologic examination, chest; single view |
4,868 |
4,082 |
$35K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,340 |
2,277 |
$33K |
| 81025 |
|
4,932 |
4,875 |
$31K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,050 |
619 |
$30K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
514 |
376 |
$30K |
| 90686 |
|
1,384 |
1,383 |
$21K |
| 99223 |
Prolong inpt eval add15 m |
158 |
155 |
$21K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
425 |
425 |
$21K |
| J3490 |
Unclassified drugs |
310 |
310 |
$21K |
| 96127 |
|
4,716 |
4,610 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
324 |
277 |
$20K |
| 99442 |
|
721 |
639 |
$20K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
774 |
576 |
$20K |
| 70450 |
Computed tomography, head or brain; without contrast material |
617 |
608 |
$19K |
| 90682 |
|
326 |
326 |
$18K |
| D0220 |
Intraoral - periapical first radiographic image |
1,332 |
865 |
$18K |
| D1206 |
Topical application of fluoride varnish |
595 |
587 |
$17K |
| D1120 |
Prophylaxis - child |
342 |
316 |
$17K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,127 |
718 |
$16K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
260 |
258 |
$16K |
| 64615 |
|
188 |
188 |
$16K |
| 88304 |
|
825 |
810 |
$14K |
| 98960 |
|
145 |
138 |
$14K |
| D0210 |
Intraoral - complete series of radiographic images |
192 |
176 |
$13K |
| 92551 |
|
1,856 |
1,856 |
$12K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
96 |
96 |
$11K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
242 |
181 |
$10K |
| 95886 |
|
170 |
162 |
$9K |
| 88342 |
|
308 |
308 |
$8K |
| 83655 |
|
603 |
602 |
$8K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
188 |
161 |
$8K |
| 99188 |
|
535 |
535 |
$7K |
| 99462 |
|
249 |
242 |
$7K |
| 95816 |
|
171 |
163 |
$7K |
| 99233 |
Prolong inpt eval add15 m |
136 |
65 |
$7K |
| 90677 |
|
26 |
26 |
$7K |
| 99443 |
|
160 |
151 |
$7K |
| 76820 |
|
328 |
186 |
$7K |
| 88141 |
|
299 |
299 |
$7K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
174 |
174 |
$6K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
255 |
250 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
385 |
275 |
$5K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
356 |
322 |
$5K |
| G0008 |
Administration of influenza virus vaccine |
363 |
363 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
25 |
25 |
$3K |
| 99173 |
|
1,912 |
1,911 |
$3K |
| 99404 |
|
43 |
27 |
$3K |
| 99080 |
|
59 |
59 |
$3K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
27 |
12 |
$3K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
40 |
40 |
$3K |
| 58340 |
|
63 |
63 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
50 |
50 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
231 |
231 |
$2K |
| 90673 |
|
31 |
29 |
$2K |
| 87210 |
|
436 |
431 |
$2K |
| 95910 |
|
13 |
13 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
181 |
181 |
$2K |
| 99441 |
|
98 |
89 |
$1K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
12 |
12 |
$1K |
| 88307 |
|
26 |
26 |
$1K |
| 95909 |
|
13 |
13 |
$1K |
| 85018 |
|
618 |
618 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
17 |
17 |
$1K |
| 99381 |
|
24 |
15 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
118 |
118 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
17 |
13 |
$995.81 |
| 99406 |
|
78 |
78 |
$914.64 |
| 76825 |
|
13 |
13 |
$826.72 |
| 83986 |
|
289 |
285 |
$759.51 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
26 |
25 |
$721.91 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
13 |
13 |
$683.48 |
| D0270 |
|
44 |
37 |
$678.36 |
| 95885 |
|
12 |
12 |
$678.16 |
| 90715 |
|
14 |
14 |
$677.30 |
| 94729 |
|
102 |
102 |
$652.81 |
| 81002 |
|
245 |
243 |
$630.99 |
| 73630 |
|
74 |
74 |
$488.57 |
| 94727 |
|
41 |
41 |
$378.80 |
| 73130 |
|
55 |
54 |
$370.82 |
| 90656 |
|
31 |
31 |
$318.95 |
| 76827 |
|
13 |
13 |
$285.69 |
| 94060 |
|
24 |
24 |
$227.85 |
| 73610 |
|
29 |
29 |
$204.77 |
| 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) |
14 |
14 |
$201.60 |
| 90688 |
|
12 |
12 |
$199.99 |
| G0009 |
Administration of pneumococcal vaccine |
16 |
16 |
$186.56 |
| 74740 |
|
13 |
13 |
$134.91 |
| 88302 |
|
12 |
12 |
$121.91 |
| 73030 |
|
13 |
12 |
$100.20 |
| 82947 |
|
14 |
14 |
$63.18 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
14 |
$31.05 |