| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
96,111 |
87,317 |
$6.24M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
22,725 |
20,261 |
$1.54M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,815 |
13,795 |
$1.21M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17,618 |
17,394 |
$1.18M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
8,269 |
8,183 |
$389K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
10,364 |
9,886 |
$235K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
47,364 |
45,780 |
$143K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,025 |
3,976 |
$109K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
37,891 |
33,045 |
$79K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,788 |
1,743 |
$73K |
| 99051 |
|
16,407 |
15,482 |
$72K |
| 99460 |
|
1,033 |
1,027 |
$69K |
| 90461 |
|
4,697 |
4,637 |
$61K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
996 |
986 |
$55K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,915 |
2,829 |
$49K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21,369 |
20,645 |
$49K |
| 90686 |
|
13,803 |
13,468 |
$41K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
439 |
434 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,727 |
5,643 |
$31K |
| 91307 |
|
818 |
701 |
$24K |
| 17110 |
|
375 |
356 |
$23K |
| 99381 |
|
464 |
451 |
$23K |
| 96127 |
|
14,252 |
13,482 |
$22K |
| 99463 |
|
261 |
257 |
$21K |
| 99383 |
|
321 |
319 |
$15K |
| 90474 |
|
4,623 |
4,495 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
326 |
311 |
$11K |
| 99382 |
|
232 |
231 |
$11K |
| 99177 |
|
18,289 |
17,956 |
$11K |
| 99188 |
|
3,935 |
3,896 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,009 |
791 |
$8K |
| 99493 |
|
729 |
716 |
$7K |
| 87634 |
|
156 |
152 |
$7K |
| 91308 |
|
197 |
172 |
$7K |
| 99462 |
|
211 |
181 |
$6K |
| 36416 |
|
3,695 |
3,270 |
$5K |
| 99492 |
|
357 |
354 |
$4K |
| 91300 |
|
132 |
111 |
$4K |
| 90473 |
|
1,190 |
1,160 |
$4K |
| 96161 |
|
10,710 |
9,545 |
$4K |
| 99215 |
Prolong outpt/office vis |
31 |
31 |
$3K |
| 90670 |
|
6,381 |
6,104 |
$3K |
| 90672 |
|
1,138 |
1,102 |
$2K |
| 91320 |
|
142 |
142 |
$2K |
| 90698 |
|
3,979 |
3,838 |
$2K |
| 99173 |
|
2,870 |
2,842 |
$2K |
| 0071A |
|
335 |
290 |
$2K |
| 81002 |
|
823 |
783 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
109 |
109 |
$2K |
| 81003 |
|
942 |
873 |
$2K |
| 90480 |
|
587 |
587 |
$2K |
| 90656 |
|
1,977 |
1,971 |
$2K |
| 0173A |
|
57 |
52 |
$2K |
| 99384 |
|
68 |
66 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,330 |
2,173 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
576 |
526 |
$2K |
| 90697 |
|
5,894 |
5,791 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
102 |
53 |
$1K |
| 0124A |
|
55 |
51 |
$1K |
| 99494 |
|
202 |
201 |
$1K |
| 0154A |
|
33 |
32 |
$1K |
| 85018 |
|
1,176 |
1,165 |
$1K |
| 0072A |
|
212 |
192 |
$1K |
| 90680 |
|
6,733 |
6,579 |
$952.52 |
| 83655 |
|
949 |
942 |
$917.96 |
| 94010 |
|
177 |
172 |
$888.26 |
| 90633 |
|
3,593 |
3,537 |
$851.96 |
| G0312 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes) |
76 |
75 |
$851.75 |
| 96381 |
|
211 |
206 |
$709.13 |
| 90620 |
|
712 |
697 |
$631.56 |
| 90651 |
|
1,935 |
1,909 |
$550.02 |
| 90671 |
|
5,575 |
5,517 |
$499.75 |
| 91312 |
|
55 |
51 |
$475.32 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
418 |
175 |
$431.87 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
67 |
64 |
$317.38 |
| 85013 |
|
588 |
575 |
$313.44 |
| 90716 |
|
1,183 |
1,170 |
$308.16 |
| 90707 |
|
1,215 |
1,199 |
$305.92 |
| 80061 |
Lipid panel |
69 |
68 |
$291.07 |
| 90710 |
|
1,597 |
1,574 |
$270.15 |
| 90744 |
|
550 |
525 |
$182.37 |
| 90715 |
|
1,080 |
1,068 |
$149.96 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
37 |
36 |
$141.03 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
74 |
71 |
$139.59 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
25 |
25 |
$127.06 |
| 91318 |
|
223 |
223 |
$121.27 |
| 82947 |
|
32 |
29 |
$114.63 |
| 90660 |
|
398 |
396 |
$114.25 |
| 82948 |
|
73 |
70 |
$106.32 |
| 96380 |
|
81 |
81 |
$102.49 |
| 90685 |
|
262 |
255 |
$86.41 |
| 36415 |
Collection of venous blood by venipuncture |
24 |
24 |
$67.14 |
| 90696 |
|
1,235 |
1,219 |
$59.39 |
| 0081A |
|
42 |
40 |
$40.00 |
| 96160 |
|
432 |
420 |
$22.91 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
216 |
201 |
$12.53 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
195 |
185 |
$9.77 |
| A7015 |
Aerosol mask, used with dme nebulizer |
157 |
148 |
$7.91 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
132 |
120 |
$7.76 |
| 90619 |
|
1,505 |
1,486 |
$0.01 |
| 90700 |
|
207 |
205 |
$0.00 |
| 90734 |
|
26 |
26 |
$0.00 |
| 90380 |
|
94 |
91 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
82 |
79 |
$0.00 |
| 90713 |
|
27 |
26 |
$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) |
35 |
33 |
$0.00 |
| 0002A |
|
19 |
16 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 91319 |
|
156 |
156 |
$0.00 |
| 90381 |
|
192 |
190 |
$0.00 |
| 0001A |
|
37 |
25 |
$0.00 |
| 91317 |
|
59 |
55 |
$0.00 |
| 90378 |
|
14 |
12 |
$0.00 |
| 91315 |
|
36 |
35 |
$0.00 |