| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,721 |
20,104 |
$1.42M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,231 |
10,786 |
$1.24M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,216 |
4,216 |
$620K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,790 |
5,790 |
$537K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,090 |
5,039 |
$467K |
| 99215 |
Prolong outpt/office vis |
2,657 |
2,592 |
$453K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,358 |
2,161 |
$264K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,423 |
1,411 |
$243K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
24,674 |
19,298 |
$198K |
| 31231 |
|
1,195 |
1,165 |
$182K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,391 |
1,384 |
$168K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
3,014 |
1,675 |
$149K |
| 76770 |
|
1,459 |
1,453 |
$136K |
| 88307 |
|
1,198 |
1,197 |
$112K |
| 99233 |
Prolong inpt eval add15 m |
1,094 |
494 |
$106K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
518 |
518 |
$93K |
| 99205 |
Prolong outpt/office vis |
399 |
399 |
$88K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,044 |
1,037 |
$74K |
| 93923 |
|
1,308 |
1,205 |
$68K |
| 93970 |
|
1,789 |
1,707 |
$66K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
259 |
259 |
$64K |
| 93971 |
|
1,831 |
1,757 |
$59K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
206 |
206 |
$47K |
| 31579 |
|
304 |
296 |
$44K |
| 31237 |
|
192 |
117 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,552 |
3,551 |
$40K |
| 99223 |
Prolong inpt eval add15 m |
221 |
221 |
$38K |
| 00731 |
|
204 |
204 |
$37K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
504 |
503 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
283 |
282 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
302 |
301 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
551 |
498 |
$24K |
| 95251 |
|
655 |
654 |
$24K |
| 92567 |
|
1,441 |
1,434 |
$20K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,784 |
1,780 |
$20K |
| 59025 |
Fetal non-stress test |
490 |
316 |
$20K |
| 88342 |
|
422 |
420 |
$19K |
| 97803 |
|
635 |
629 |
$18K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
141 |
36 |
$18K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
234 |
234 |
$17K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
117 |
81 |
$16K |
| 31575 |
|
147 |
145 |
$15K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
136 |
136 |
$15K |
| 92504 |
|
580 |
554 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
707 |
704 |
$13K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
420 |
271 |
$11K |
| 99221 |
|
149 |
126 |
$10K |
| 99222 |
Initial hospital care, per day, moderate complexity |
102 |
101 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
64 |
64 |
$7K |
| 69210 |
|
195 |
191 |
$7K |
| 94010 |
|
199 |
198 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
46 |
24 |
$5K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
61 |
50 |
$5K |
| 96112 |
|
38 |
38 |
$5K |
| 92557 |
|
145 |
144 |
$4K |
| 88304 |
|
323 |
322 |
$4K |
| 99443 |
|
35 |
34 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
38 |
28 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
57 |
57 |
$4K |
| 99442 |
|
44 |
43 |
$3K |
| 81002 |
|
1,168 |
1,136 |
$3K |
| 92551 |
|
258 |
258 |
$3K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
20 |
20 |
$3K |
| 76825 |
|
12 |
12 |
$3K |
| 00920 |
|
14 |
14 |
$3K |
| 99236 |
Prolong inpt eval add15 m |
12 |
12 |
$3K |
| 88141 |
|
165 |
165 |
$3K |
| 84165 |
|
159 |
156 |
$3K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
25 |
24 |
$2K |
| 51798 |
|
237 |
235 |
$2K |
| 99441 |
|
43 |
43 |
$2K |
| 90686 |
|
1,389 |
1,388 |
$2K |
| 99051 |
|
236 |
235 |
$2K |
| 92015 |
Determination of refractive state |
305 |
304 |
$2K |
| 72082 |
|
49 |
25 |
$2K |
| 51741 |
|
114 |
114 |
$1K |
| 46600 |
|
12 |
12 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
12 |
$1K |
| 88112 |
|
42 |
39 |
$1K |
| 88189 |
|
14 |
14 |
$1K |
| 88173 |
|
12 |
12 |
$880.44 |
| 95816 |
|
13 |
13 |
$787.15 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
134 |
132 |
$630.00 |
| 92556 |
|
18 |
18 |
$548.87 |
| 92552 |
|
18 |
18 |
$459.24 |
| 86334 |
|
31 |
31 |
$457.98 |
| 81000 |
|
97 |
95 |
$332.70 |
| 99188 |
|
26 |
26 |
$332.28 |
| 93325 |
|
12 |
12 |
$259.87 |
| 99152 |
|
27 |
26 |
$250.28 |
| 95117 |
|
21 |
12 |
$241.08 |
| 85018 |
|
82 |
82 |
$209.32 |
| 93000 |
|
12 |
12 |
$163.13 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$112.50 |
| 96161 |
|
27 |
27 |
$69.25 |
| 96127 |
|
14 |
14 |
$67.48 |
| 96160 |
|
14 |
14 |
$39.20 |
| 36415 |
Collection of venous blood by venipuncture |
476 |
452 |
$23.14 |
| 99173 |
|
766 |
765 |
$3.08 |
| 94760 |
|
119 |
119 |
$2.35 |
| 90670 |
|
142 |
142 |
$0.00 |
| 90461 |
|
516 |
516 |
$0.00 |
| 1159F |
|
41 |
39 |
$0.00 |
| 3078F |
|
21 |
19 |
$0.00 |
| 36416 |
|
104 |
103 |
$0.00 |
| 99024 |
|
2,682 |
1,953 |
$0.00 |
| 90680 |
|
55 |
55 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
635 |
634 |
$0.00 |
| 94762 |
|
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
160 |
159 |
$0.00 |
| 90647 |
|
44 |
44 |
$0.00 |
| 90723 |
|
62 |
62 |
$0.00 |
| 1000F |
|
17 |
16 |
$0.00 |
| 3008F |
|
35 |
33 |
$0.00 |
| 3074F |
|
16 |
16 |
$0.00 |
| 2000F |
|
30 |
28 |
$0.00 |