| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55,486 |
45,439 |
$3.04M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29,649 |
25,230 |
$2.24M |
| 99199 |
Unlisted special service, procedure or report |
372,227 |
200,492 |
$2.21M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
9,435 |
8,306 |
$872K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,932 |
7,454 |
$764K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,245 |
5,353 |
$544K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13,511 |
11,762 |
$504K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23,642 |
20,636 |
$443K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,123 |
2,675 |
$303K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14,419 |
12,322 |
$125K |
| 96127 |
|
28,423 |
24,492 |
$116K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,763 |
2,165 |
$81K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
989 |
719 |
$73K |
| 90474 |
|
3,407 |
3,037 |
$65K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,742 |
1,629 |
$59K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,922 |
1,629 |
$51K |
| 99243 |
|
493 |
454 |
$36K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,592 |
2,220 |
$34K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
302 |
234 |
$34K |
| D1206 |
Topical application of fluoride varnish |
1,741 |
1,628 |
$26K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
670 |
518 |
$25K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,264 |
1,213 |
$23K |
| 99215 |
Prolong outpt/office vis |
263 |
230 |
$21K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
428 |
350 |
$13K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
265 |
211 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
178 |
139 |
$10K |
| 90651 |
|
823 |
720 |
$9K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
5,236 |
4,450 |
$7K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,387 |
1,142 |
$6K |
| 90686 |
|
8,277 |
7,382 |
$5K |
| 83655 |
|
736 |
717 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
111 |
111 |
$4K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
31 |
29 |
$4K |
| 97597 |
|
265 |
116 |
$4K |
| 0002A |
|
51 |
43 |
$3K |
| 69210 |
|
147 |
132 |
$3K |
| 99442 |
|
66 |
57 |
$3K |
| 0001A |
|
43 |
43 |
$3K |
| 31231 |
|
69 |
57 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
67 |
66 |
$3K |
| 90734 |
|
411 |
347 |
$2K |
| 99441 |
|
111 |
70 |
$2K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
126 |
69 |
$2K |
| 96161 |
|
549 |
539 |
$2K |
| 99383 |
|
15 |
13 |
$2K |
| 0071A |
|
33 |
27 |
$2K |
| 76813 |
|
32 |
32 |
$1K |
| 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) |
305 |
294 |
$1K |
| 99406 |
|
135 |
125 |
$1K |
| 0072A |
|
15 |
14 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
368 |
269 |
$952.15 |
| 92551 |
|
12,129 |
10,483 |
$839.61 |
| 90620 |
|
55 |
51 |
$579.15 |
| 90633 |
|
2,564 |
2,346 |
$557.81 |
| 92558 |
|
283 |
275 |
$437.36 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
13 |
$423.50 |
| 99173 |
|
10,763 |
9,229 |
$355.61 |
| 92587 |
|
1,177 |
928 |
$322.14 |
| 81003 |
|
137 |
131 |
$306.89 |
| 87807 |
|
12 |
12 |
$169.56 |
| 96380 |
|
12 |
12 |
$154.26 |
| 90715 |
|
41 |
37 |
$120.33 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$118.50 |
| 96160 |
|
27 |
26 |
$89.76 |
| 85018 |
|
158 |
151 |
$29.20 |
| 36416 |
|
617 |
504 |
$6.41 |
| 90723 |
|
4,524 |
3,995 |
$0.00 |
| 90647 |
|
4,512 |
4,020 |
$0.00 |
| 90680 |
|
3,435 |
3,085 |
$0.00 |
| 90677 |
|
592 |
591 |
$0.00 |
| 3074F |
|
571 |
558 |
$0.00 |
| 3008F |
|
286 |
279 |
$0.00 |
| 90716 |
|
91 |
88 |
$0.00 |
| 90656 |
|
303 |
295 |
$0.00 |
| 90696 |
|
155 |
131 |
$0.00 |
| 90685 |
|
42 |
42 |
$0.00 |
| 90670 |
|
5,923 |
5,147 |
$0.00 |
| 1159F |
|
1,047 |
1,019 |
$0.00 |
| 1160F |
|
1,047 |
1,019 |
$0.00 |
| 3078F |
|
602 |
587 |
$0.00 |
| 90707 |
|
80 |
77 |
$0.00 |
| 90710 |
|
229 |
194 |
$0.00 |
| 90700 |
|
87 |
82 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
39 |
12 |
$0.00 |