| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
57,836 |
53,977 |
$3.84M |
| T1017 |
Targeted case management, each 15 minutes |
191,588 |
72,493 |
$3.55M |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
7,718 |
2,168 |
$2.82M |
| H1000 |
Prenatal care, at-risk assessment |
33,309 |
29,271 |
$1.98M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41,331 |
38,278 |
$1.75M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
20,045 |
18,318 |
$1.27M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14,706 |
13,946 |
$1.06M |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
3,045 |
812 |
$1.04M |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
11,465 |
10,784 |
$996K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
8,842 |
2,927 |
$948K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
7,906 |
2,984 |
$864K |
| 99233 |
Prolong inpt eval add15 m |
10,590 |
4,481 |
$835K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
13,779 |
6,584 |
$757K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
17,528 |
16,204 |
$727K |
| 99215 |
Prolong outpt/office vis |
6,143 |
5,762 |
$668K |
| T1024 |
Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter |
7,503 |
6,342 |
$562K |
| 99222 |
Initial hospital care, per day, moderate complexity |
3,686 |
3,259 |
$431K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,213 |
4,967 |
$409K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
20,144 |
18,411 |
$385K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
8,294 |
7,295 |
$370K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,224 |
3,034 |
$363K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
12,030 |
9,955 |
$333K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,028 |
3,862 |
$286K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,423 |
2,254 |
$285K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
3,045 |
2,877 |
$257K |
| 99221 |
|
2,789 |
2,386 |
$236K |
| 99223 |
Prolong inpt eval add15 m |
882 |
769 |
$150K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
758 |
320 |
$137K |
| T1027 |
Family training and counseling for child development, per 15 minutes |
2,805 |
1,271 |
$121K |
| 0502F |
|
32,843 |
27,758 |
$106K |
| 31231 |
|
461 |
434 |
$100K |
| 59430 |
|
1,915 |
1,804 |
$94K |
| 99254 |
|
931 |
794 |
$91K |
| 99217 |
|
1,399 |
1,336 |
$82K |
| 99220 |
|
506 |
490 |
$79K |
| 99219 |
|
670 |
645 |
$75K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
139 |
67 |
$71K |
| 99188 |
|
6,791 |
6,434 |
$69K |
| 54150 |
|
612 |
575 |
$60K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
633 |
568 |
$56K |
| 90837 |
Psychotherapy, 53 minutes with patient |
729 |
416 |
$55K |
| 99205 |
Prolong outpt/office vis |
317 |
291 |
$54K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
564 |
530 |
$49K |
| 59410 |
|
47 |
45 |
$49K |
| 99245 |
|
265 |
242 |
$44K |
| 99255 |
|
215 |
193 |
$43K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
639 |
613 |
$41K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
310 |
278 |
$40K |
| 76830 |
Ultrasound, transvaginal |
591 |
550 |
$39K |
| 59025 |
Fetal non-stress test |
2,355 |
1,682 |
$37K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
264 |
263 |
$35K |
| 96161 |
|
7,054 |
6,334 |
$29K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12,848 |
11,700 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
303 |
292 |
$25K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
207 |
200 |
$25K |
| 94760 |
|
5,688 |
4,756 |
$25K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
995 |
740 |
$23K |
| 87428 |
|
677 |
622 |
$23K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
186 |
170 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,022 |
976 |
$21K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
524 |
170 |
$20K |
| 59515 |
|
15 |
14 |
$18K |
| 92134 |
|
984 |
837 |
$17K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
253 |
102 |
$17K |
| 92060 |
|
403 |
378 |
$15K |
| 95117 |
|
1,348 |
657 |
$13K |
| 0002A |
|
345 |
332 |
$13K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
231 |
217 |
$11K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,008 |
1,444 |
$11K |
| 0001A |
|
361 |
344 |
$11K |
| 95819 |
|
148 |
121 |
$10K |
| 76820 |
|
1,570 |
1,232 |
$9K |
| 94664 |
|
109 |
107 |
$8K |
| 94010 |
|
451 |
403 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,169 |
2,063 |
$8K |
| 99417 |
Prolong home eval add 15m |
1,003 |
727 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
415 |
361 |
$8K |
| 99242 |
|
178 |
157 |
$8K |
| 96401 |
|
140 |
97 |
$8K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
50 |
50 |
$7K |
| 99253 |
|
98 |
84 |
$7K |
| 92551 |
|
2,791 |
2,505 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
136 |
131 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
142 |
124 |
$6K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
89 |
37 |
$6K |
| 16020 |
|
94 |
82 |
$5K |
| 93000 |
|
892 |
849 |
$5K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
73 |
70 |
$5K |
| 64615 |
|
82 |
81 |
$5K |
| 76801 |
|
120 |
118 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
270 |
250 |
$5K |
| 90461 |
|
746 |
708 |
$4K |
| 82962 |
|
374 |
360 |
$4K |
| 99460 |
|
51 |
49 |
$4K |
| 99243 |
|
64 |
61 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
37 |
31 |
$3K |
| 77427 |
|
23 |
13 |
$3K |
| 90686 |
|
5,026 |
4,704 |
$3K |
| 99442 |
|
117 |
116 |
$3K |
| G8484 |
Influenza immunization was not administered, reason not given |
33,300 |
29,277 |
$3K |
| 93298 |
|
135 |
127 |
$2K |
| 99464 |
|
37 |
36 |
$2K |
| 99235 |
|
14 |
13 |
$2K |
| 96112 |
|
86 |
67 |
$2K |
| 99252 |
|
41 |
36 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
357 |
341 |
$2K |
| 95782 |
|
14 |
14 |
$2K |
| 93308 |
|
54 |
53 |
$2K |
| 99236 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| 99173 |
|
2,521 |
2,263 |
$2K |
| 92100 |
|
39 |
39 |
$2K |
| 0503F |
|
1,783 |
1,603 |
$2K |
| 82948 |
|
1,120 |
1,065 |
$2K |
| 96132 |
|
16 |
14 |
$1K |
| 95115 |
|
146 |
73 |
$1K |
| 93296 |
|
152 |
146 |
$1K |
| 90670 |
|
4,022 |
3,725 |
$1K |
| 97802 |
|
2,376 |
2,165 |
$1K |
| 93015 |
|
49 |
45 |
$1K |
| 95806 |
|
315 |
306 |
$1K |
| 90480 |
|
66 |
60 |
$1K |
| 20610 |
|
36 |
26 |
$1K |
| 0124A |
|
45 |
37 |
$1K |
| 83655 |
|
306 |
293 |
$958.65 |
| 96116 |
|
19 |
12 |
$853.73 |
| 96127 |
|
6,374 |
5,570 |
$849.38 |
| 96160 |
|
8,257 |
7,138 |
$801.72 |
| 99443 |
|
28 |
27 |
$787.57 |
| 90677 |
|
133 |
108 |
$700.19 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
28,618 |
24,108 |
$525.62 |
| 94729 |
|
72 |
72 |
$500.65 |
| 92250 |
|
25 |
25 |
$496.35 |
| J2785 |
Injection, regadenoson, 0.1 mg |
14 |
13 |
$471.12 |
| 94726 |
|
52 |
52 |
$432.53 |
| 72110 |
|
16 |
12 |
$427.89 |
| 0003A |
|
44 |
30 |
$423.20 |
| 36415 |
Collection of venous blood by venipuncture |
173 |
169 |
$415.87 |
| 90647 |
|
1,733 |
1,576 |
$361.01 |
| 90681 |
|
444 |
411 |
$350.00 |
| 93016 |
|
16 |
14 |
$326.45 |
| 85018 |
|
779 |
729 |
$321.30 |
| 96113 |
|
87 |
66 |
$304.97 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
25 |
16 |
$286.78 |
| 94375 |
|
15 |
13 |
$284.70 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
203 |
111 |
$248.86 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
6,236 |
5,289 |
$225.45 |
| 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) |
688 |
640 |
$190.56 |
| 93356 |
|
41 |
41 |
$186.77 |
| 90674 |
|
100 |
87 |
$175.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
24 |
$163.00 |
| 81002 |
|
486 |
459 |
$153.02 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
13 |
$129.42 |
| 1111F |
|
1,190 |
881 |
$122.50 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
15 |
13 |
$122.28 |
| G8482 |
Influenza immunization administered or previously received |
6,803 |
6,198 |
$118.41 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,723 |
1,479 |
$69.23 |
| 90633 |
|
251 |
224 |
$60.00 |
| 93321 |
|
26 |
26 |
$50.37 |
| 90697 |
|
285 |
252 |
$38.00 |
| 93325 |
|
47 |
42 |
$37.77 |
| 90685 |
|
14 |
12 |
$33.00 |
| 93018 |
|
17 |
15 |
$28.86 |
| 90723 |
|
1,991 |
1,829 |
$10.00 |
| 1036F |
|
16,668 |
14,115 |
$0.00 |
| 87276 |
|
12 |
12 |
$0.00 |
| G8432 |
Depression screening not documented, reason not given |
4,318 |
4,084 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
171 |
152 |
$0.00 |
| 3017F |
|
911 |
791 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
512 |
453 |
$0.00 |
| 88720 |
|
46 |
35 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
134 |
112 |
$0.00 |
| 4010F |
|
80 |
70 |
$0.00 |
| 3074F |
|
125 |
110 |
$0.00 |
| 3075F |
|
13 |
12 |
$0.00 |
| G9717 |
Documentation stating the patient has had a diagnosis of bipolar disorder |
13 |
13 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
17 |
17 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
12 |
$0.00 |
| 91307 |
|
16 |
13 |
$0.00 |
| 91318 |
|
15 |
14 |
$0.00 |
| 36416 |
|
13 |
13 |
$0.00 |
| 96139 |
|
19 |
13 |
$0.00 |
| 2022F |
|
1,261 |
1,112 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
288 |
253 |
$0.00 |
| 83037 |
|
125 |
111 |
$0.00 |
| G8421 |
Bmi not documented and no reason is given |
237 |
188 |
$0.00 |
| 3078F |
|
168 |
147 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
28 |
26 |
$0.00 |
| 4004F |
|
49 |
37 |
$0.00 |
| G9900 |
Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified |
12 |
12 |
$0.00 |
| 90700 |
|
31 |
26 |
$0.00 |
| 95251 |
|
16 |
14 |
$0.00 |
| 91312 |
|
15 |
14 |
$0.00 |
| 91300 |
|
74 |
74 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 96138 |
|
19 |
13 |
$0.00 |
| 3046F |
|
59 |
52 |
$0.00 |
| 87275 |
|
12 |
12 |
$0.00 |
| 97803 |
|
16 |
12 |
$0.00 |