| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,059 |
23,284 |
$1.21M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,857 |
12,831 |
$934K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
7,064 |
6,845 |
$359K |
| 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 |
1,992 |
1,927 |
$147K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,773 |
1,737 |
$119K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,449 |
1,425 |
$93K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,298 |
7,027 |
$79K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,231 |
1,136 |
$66K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,984 |
1,932 |
$65K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
899 |
875 |
$59K |
| X5622 |
|
2,102 |
2,020 |
$51K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,319 |
3,200 |
$47K |
| 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 |
1,845 |
1,794 |
$44K |
| 36415 |
Collection of venous blood by venipuncture |
11,077 |
10,157 |
$40K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,436 |
1,385 |
$36K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,618 |
2,483 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,861 |
2,640 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
253 |
242 |
$17K |
| 80061 |
Lipid panel |
1,380 |
1,350 |
$15K |
| 99188 |
|
2,596 |
2,548 |
$15K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
562 |
551 |
$15K |
| 92551 |
|
2,935 |
2,852 |
$14K |
| 71046 |
Radiologic examination, chest; 2 views |
820 |
800 |
$14K |
| 96127 |
|
3,610 |
3,498 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
436 |
429 |
$12K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,825 |
1,678 |
$11K |
| 84443 |
Thyroid stimulating hormone (TSH) |
906 |
880 |
$11K |
| 87081 |
|
1,917 |
1,823 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
179 |
176 |
$8K |
| 99215 |
Prolong outpt/office vis |
78 |
75 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
913 |
894 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,013 |
956 |
$7K |
| 80053 |
Comprehensive metabolic panel |
927 |
872 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
80 |
78 |
$7K |
| 90686 |
|
2,442 |
2,365 |
$7K |
| 99000 |
|
424 |
397 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
55 |
54 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
98 |
98 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
167 |
165 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
481 |
454 |
$3K |
| 99173 |
|
3,206 |
3,117 |
$3K |
| 90715 |
|
232 |
226 |
$3K |
| 99421 |
|
391 |
379 |
$3K |
| 85027 |
|
489 |
456 |
$2K |
| 92015 |
Determination of refractive state |
308 |
303 |
$2K |
| 86803 |
|
174 |
172 |
$2K |
| 81001 |
|
869 |
836 |
$2K |
| 36416 |
|
851 |
700 |
$2K |
| 90670 |
|
857 |
838 |
$2K |
| 87210 |
|
457 |
441 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
76 |
72 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$2K |
| 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 |
98 |
94 |
$1K |
| 0071A |
|
34 |
34 |
$1K |
| 90682 |
|
30 |
29 |
$1K |
| 90651 |
|
122 |
119 |
$1K |
| 83655 |
|
139 |
137 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
30 |
29 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
110 |
109 |
$1K |
| 81025 |
|
128 |
126 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
15 |
$911.38 |
| 99442 |
|
36 |
20 |
$891.51 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
88 |
82 |
$832.42 |
| 0072A |
|
18 |
18 |
$720.18 |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
19 |
13 |
$700.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$698.81 |
| 85018 |
|
255 |
248 |
$527.24 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
14 |
14 |
$515.41 |
| 96161 |
|
244 |
234 |
$409.28 |
| 90480 |
|
26 |
26 |
$408.60 |
| 86780 |
|
29 |
27 |
$380.89 |
| 87807 |
|
39 |
39 |
$325.10 |
| 99441 |
|
30 |
18 |
$302.01 |
| 74019 |
|
12 |
12 |
$178.48 |
| 84703 |
|
79 |
77 |
$128.80 |
| 93000 |
|
14 |
14 |
$127.99 |
| 87186 |
|
25 |
24 |
$121.09 |
| 90734 |
|
116 |
113 |
$120.73 |
| 90656 |
|
112 |
108 |
$110.06 |
| 90698 |
|
441 |
432 |
$97.00 |
| 82947 |
|
12 |
12 |
$55.46 |
| 90633 |
|
230 |
227 |
$32.50 |
| 81003 |
|
28 |
26 |
$31.24 |
| 90744 |
|
169 |
161 |
$29.28 |
| 85014 |
|
15 |
13 |
$27.13 |
| 99459 |
|
12 |
12 |
$15.21 |
| 90681 |
|
49 |
48 |
$0.00 |
| 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) |
78 |
76 |
$0.00 |
| 90685 |
|
96 |
93 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 84439 |
|
28 |
27 |
$0.00 |
| 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 |
13 |
12 |
$0.00 |
| 90680 |
|
53 |
53 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| 90716 |
|
28 |
26 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |