| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
249,055 |
236,757 |
$16.47M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
208,325 |
192,342 |
$8.48M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
70,468 |
66,068 |
$4.57M |
| 99215 |
Prolong outpt/office vis |
63,479 |
59,152 |
$3.79M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
137,177 |
126,681 |
$3.59M |
| 99233 |
Prolong inpt eval add15 m |
95,428 |
35,086 |
$2.40M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
55,712 |
34,606 |
$2.32M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
66,397 |
63,832 |
$2.20M |
| 70450 |
Computed tomography, head or brain; without contrast material |
51,435 |
45,878 |
$1.61M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
29,994 |
27,853 |
$1.38M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
18,442 |
8,695 |
$1.24M |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
3,029 |
2,863 |
$1.22M |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
187,013 |
142,081 |
$1.13M |
| 95720 |
|
8,434 |
4,766 |
$1.12M |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
15,197 |
14,378 |
$1.10M |
| 99243 |
|
17,466 |
16,759 |
$1.05M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
20,869 |
20,247 |
$1.00M |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
6,586 |
6,268 |
$932K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12,269 |
11,390 |
$847K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
8,663 |
8,012 |
$803K |
| 71045 |
Radiologic examination, chest; single view |
153,537 |
112,796 |
$796K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
11,979 |
11,307 |
$696K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
9,920 |
9,372 |
$608K |
| 95951 |
|
4,823 |
2,652 |
$575K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
16,775 |
15,598 |
$570K |
| 71046 |
Radiologic examination, chest; 2 views |
78,095 |
73,057 |
$514K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,740 |
1,659 |
$462K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
8,882 |
8,120 |
$456K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
5,992 |
5,546 |
$454K |
| 99460 |
|
4,384 |
4,145 |
$431K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
8,160 |
7,504 |
$352K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
9,907 |
8,568 |
$338K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
11,780 |
10,879 |
$336K |
| 88307 |
|
4,859 |
4,091 |
$331K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
21,139 |
8,183 |
$325K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
3,048 |
601 |
$324K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
8,435 |
6,381 |
$316K |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
908 |
277 |
$297K |
| 92015 |
Determination of refractive state |
34,427 |
29,695 |
$270K |
| 76775 |
|
8,460 |
8,103 |
$254K |
| 74018 |
|
46,957 |
37,357 |
$250K |
| 01922 |
|
1,695 |
1,611 |
$238K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
5,323 |
4,911 |
$230K |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,302 |
4,652 |
$228K |
| 93320 |
|
9,957 |
8,775 |
$224K |
| 99245 |
|
2,959 |
2,827 |
$217K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
610 |
587 |
$191K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,360 |
9,646 |
$184K |
| 92060 |
|
5,221 |
4,760 |
$172K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,715 |
1,669 |
$165K |
| 99223 |
Prolong inpt eval add15 m |
3,809 |
3,638 |
$162K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,394 |
2,144 |
$150K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,612 |
1,523 |
$149K |
| 64643 |
|
4,417 |
3,623 |
$147K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,268 |
3,002 |
$142K |
| 94010 |
|
14,713 |
13,862 |
$139K |
| 93976 |
|
3,007 |
2,833 |
$135K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
5,300 |
2,658 |
$126K |
| 64642 |
|
2,482 |
2,385 |
$123K |
| 95874 |
|
13,244 |
6,888 |
$118K |
| 96139 |
|
1,246 |
1,105 |
$111K |
| 99205 |
Prolong outpt/office vis |
1,198 |
1,079 |
$110K |
| 88112 |
|
2,635 |
2,301 |
$101K |
| 93325 |
|
20,979 |
18,385 |
$98K |
| 96158 |
|
2,088 |
1,533 |
$97K |
| 85060 |
|
6,360 |
5,676 |
$95K |
| 95782 |
|
757 |
717 |
$94K |
| 73630 |
|
12,112 |
10,229 |
$92K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,384 |
3,953 |
$91K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
2,235 |
2,115 |
$91K |
| 96132 |
|
1,034 |
911 |
$90K |
| 73610 |
|
11,512 |
10,368 |
$89K |
| 99220 |
|
1,913 |
1,825 |
$88K |
| 73560 |
|
13,084 |
10,867 |
$87K |
| 92134 |
|
7,289 |
6,218 |
$86K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,609 |
1,508 |
$85K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,210 |
2,041 |
$85K |
| 72131 |
|
1,652 |
1,519 |
$77K |
| 00731 |
|
1,128 |
1,056 |
$76K |
| 76506 |
|
2,241 |
1,750 |
$74K |
| 99242 |
|
1,748 |
1,659 |
$74K |
| 99356 |
|
1,039 |
706 |
$71K |
| 62370 |
|
1,412 |
1,379 |
$71K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
745 |
661 |
$69K |
| 90791 |
Psychiatric diagnostic evaluation |
979 |
851 |
$64K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
1,776 |
1,690 |
$55K |
| 99217 |
|
2,455 |
2,346 |
$55K |
| 64644 |
|
1,879 |
1,726 |
$54K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,443 |
1,342 |
$54K |
| 92504 |
|
2,472 |
2,346 |
$53K |
| 88141 |
|
2,859 |
2,645 |
$53K |
| 84165 |
|
4,969 |
4,382 |
$51K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
2,684 |
1,670 |
$50K |
| 71250 |
|
1,542 |
1,432 |
$50K |
| 96133 |
|
458 |
412 |
$48K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,191 |
1,133 |
$48K |
| 86334 |
|
4,641 |
4,088 |
$48K |
| 72128 |
|
1,015 |
937 |
$47K |
| 70486 |
|
995 |
914 |
$47K |
| 73590 |
|
5,696 |
4,773 |
$46K |
| 99292 |
|
847 |
269 |
$45K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
688 |
650 |
$45K |
| 76813 |
|
1,101 |
1,020 |
$44K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
200 |
194 |
$44K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
752 |
702 |
$44K |
| 64615 |
|
846 |
799 |
$43K |
| 90837 |
Psychotherapy, 53 minutes with patient |
467 |
316 |
$43K |
| 96118 |
|
263 |
244 |
$42K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
726 |
697 |
$41K |
| 73090 |
|
4,680 |
4,158 |
$40K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,584 |
1,523 |
$38K |
| 96119 |
|
250 |
229 |
$38K |
| 95819 |
|
1,328 |
1,276 |
$38K |
| 88342 |
|
1,540 |
1,247 |
$37K |
| 96112 |
|
365 |
308 |
$36K |
| 73030 |
|
5,356 |
4,625 |
$36K |
| 73130 |
|
4,863 |
4,071 |
$35K |
| 90961 |
|
545 |
505 |
$34K |
| 99462 |
|
1,111 |
773 |
$34K |
| 74230 |
|
2,365 |
2,147 |
$33K |
| 96138 |
|
1,358 |
1,193 |
$33K |
| 99199 |
Unlisted special service, procedure or report |
243 |
148 |
$32K |
| 70496 |
|
497 |
446 |
$31K |
| 96116 |
|
468 |
405 |
$29K |
| 96156 |
|
435 |
400 |
$29K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
258 |
89 |
$29K |
| 99471 |
|
40 |
38 |
$29K |
| 72082 |
|
2,507 |
2,416 |
$29K |
| 00126 |
|
345 |
335 |
$28K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
649 |
588 |
$28K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
812 |
776 |
$27K |
| 96136 |
|
823 |
746 |
$26K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
93 |
25 |
$24K |
| 70498 |
|
378 |
349 |
$24K |
| 95953 |
|
189 |
100 |
$24K |
| 93016 |
|
1,794 |
1,704 |
$24K |
| 73070 |
|
3,307 |
2,977 |
$23K |
| 49452 |
|
40 |
38 |
$23K |
| 96152 |
|
629 |
430 |
$22K |
| 90945 |
|
593 |
115 |
$22K |
| 93321 |
|
2,927 |
2,625 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,476 |
1,291 |
$21K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
759 |
715 |
$21K |
| 72170 |
|
2,684 |
2,561 |
$21K |
| 76642 |
|
1,007 |
961 |
$21K |
| 73100 |
|
2,640 |
2,397 |
$21K |
| 93018 |
|
2,220 |
2,079 |
$20K |
| 74019 |
|
2,470 |
2,231 |
$20K |
| 95954 |
|
195 |
114 |
$20K |
| 95811 |
|
359 |
334 |
$20K |
| 92133 |
|
1,357 |
1,132 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
779 |
699 |
$19K |
| 72081 |
|
2,090 |
1,997 |
$19K |
| 72141 |
|
322 |
300 |
$19K |
| 99222 |
Initial hospital care, per day, moderate complexity |
457 |
446 |
$18K |
| 86077 |
|
1,548 |
1,071 |
$18K |
| 99255 |
|
244 |
225 |
$18K |
| 88108 |
|
944 |
745 |
$17K |
| 88304 |
|
1,726 |
1,559 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
281 |
270 |
$16K |
| 92201 |
|
912 |
583 |
$16K |
| 96167 |
|
313 |
274 |
$15K |
| 17110 |
|
722 |
680 |
$15K |
| 94618 |
|
1,849 |
1,729 |
$15K |
| G0316 |
Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes) |
266 |
94 |
$14K |
| 85576 |
|
809 |
740 |
$13K |
| 76801 |
|
289 |
270 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
213 |
203 |
$13K |
| 77092 |
|
884 |
842 |
$13K |
| 73140 |
|
1,966 |
1,855 |
$13K |
| 92083 |
|
970 |
802 |
$13K |
| 94060 |
|
1,719 |
1,600 |
$12K |
| 93000 |
|
937 |
894 |
$12K |
| 73552 |
|
1,835 |
1,587 |
$11K |
| 93922 |
|
1,929 |
1,776 |
$11K |
| 31575 |
|
96 |
91 |
$11K |
| 36557 |
|
15 |
13 |
$11K |
| 93971 |
|
848 |
785 |
$11K |
| 94726 |
|
1,951 |
1,803 |
$11K |
| 74183 |
|
220 |
197 |
$11K |
| 73502 |
|
2,009 |
1,837 |
$10K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
673 |
644 |
$10K |
| 98940 |
|
749 |
388 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
629 |
483 |
$10K |
| 94729 |
|
2,829 |
2,635 |
$10K |
| 20611 |
|
254 |
228 |
$10K |
| 96130 |
|
109 |
103 |
$10K |
| 99476 |
|
27 |
12 |
$9K |
| 93308 |
|
491 |
434 |
$9K |
| V5266 |
Battery for use in hearing device |
821 |
800 |
$9K |
| G2212 |
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) |
292 |
235 |
$9K |
| 93295 |
|
417 |
390 |
$9K |
| 76536 |
|
346 |
335 |
$9K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
568 |
234 |
$9K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
328 |
275 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
138 |
133 |
$8K |
| 76830 |
Ultrasound, transvaginal |
267 |
259 |
$8K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
31 |
28 |
$8K |
| 73110 |
|
1,062 |
955 |
$8K |
| 99253 |
|
125 |
121 |
$8K |
| 92226 |
|
426 |
294 |
$7K |
| 64616 |
|
193 |
187 |
$7K |
| 84166 |
|
566 |
513 |
$7K |
| 99254 |
|
123 |
106 |
$7K |
| 99201 |
|
266 |
255 |
$7K |
| 96159 |
|
345 |
293 |
$6K |
| 42830 |
|
39 |
37 |
$6K |
| 72146 |
|
76 |
74 |
$6K |
| 76937 |
|
301 |
278 |
$6K |
| 80500 |
|
351 |
277 |
$6K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
221 |
155 |
$6K |
| 95719 |
|
47 |
36 |
$6K |
| 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) |
4,665 |
4,403 |
$6K |
| 95886 |
|
196 |
182 |
$6K |
| 49446 |
|
12 |
12 |
$5K |
| 76770 |
|
224 |
218 |
$5K |
| 77065 |
Tomosynthesis, mammo |
242 |
228 |
$5K |
| 99241 |
|
177 |
164 |
$5K |
| 20610 |
|
236 |
183 |
$5K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
132 |
128 |
$5K |
| 96910 |
|
210 |
50 |
$5K |
| 36512 |
|
141 |
121 |
$5K |
| 72100 |
|
615 |
575 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
320 |
305 |
$5K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
307 |
301 |
$5K |
| 71550 |
|
52 |
51 |
$4K |
| 99173 |
|
249 |
231 |
$4K |
| 77080 |
|
1,029 |
994 |
$4K |
| 93304 |
|
122 |
104 |
$4K |
| 88312 |
|
232 |
178 |
$4K |
| 70360 |
|
497 |
484 |
$4K |
| 85097 |
|
114 |
94 |
$4K |
| 31579 |
|
41 |
37 |
$4K |
| 80503 |
|
289 |
235 |
$3K |
| 99140 |
|
49 |
43 |
$3K |
| D0160 |
|
78 |
72 |
$3K |
| 92250 |
|
308 |
232 |
$3K |
| 88189 |
|
45 |
40 |
$3K |
| 99234 |
|
31 |
24 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
53 |
$3K |
| 80502 |
|
64 |
55 |
$3K |
| 86335 |
|
277 |
245 |
$3K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
17 |
12 |
$3K |
| 25600 |
|
20 |
18 |
$3K |
| 95718 |
|
30 |
26 |
$3K |
| 77066 |
Tomosynthesis, mammo |
93 |
89 |
$3K |
| 95957 |
|
71 |
35 |
$3K |
| 76825 |
|
68 |
51 |
$2K |
| 73221 |
|
66 |
61 |
$2K |
| 88313 |
|
177 |
105 |
$2K |
| 76820 |
|
93 |
64 |
$2K |
| 77001 |
|
232 |
211 |
$2K |
| 95806 |
|
59 |
51 |
$2K |
| 95816 |
|
62 |
61 |
$2K |
| 99188 |
|
163 |
148 |
$2K |
| 43235 |
|
15 |
13 |
$2K |
| 96131 |
|
32 |
26 |
$2K |
| 77062 |
|
40 |
37 |
$2K |
| 96168 |
|
90 |
82 |
$2K |
| 72040 |
|
161 |
155 |
$2K |
| 74240 |
|
45 |
44 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
27 |
$2K |
| 77090 |
|
846 |
808 |
$2K |
| 88341 |
|
57 |
42 |
$2K |
| 76377 |
|
39 |
38 |
$1K |
| 54150 |
|
29 |
25 |
$1K |
| 52000 |
|
26 |
24 |
$1K |
| 85250 |
|
535 |
416 |
$1K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
47 |
40 |
$1K |
| 00920 |
|
12 |
12 |
$1K |
| 99100 |
|
14 |
14 |
$1K |
| 77072 |
|
200 |
197 |
$1K |
| 76827 |
|
68 |
51 |
$1K |
| 82105 |
|
443 |
405 |
$1K |
| 00142 |
|
46 |
42 |
$1K |
| 77061 |
|
55 |
49 |
$1K |
| 93750 |
|
37 |
12 |
$1K |
| 77073 |
|
98 |
95 |
$1K |
| 99219 |
|
32 |
27 |
$981.49 |
| D0330 |
Panoramic radiographic image |
27 |
24 |
$968.95 |
| 87154 |
|
158 |
127 |
$921.45 |
| 93227 |
|
63 |
56 |
$875.52 |
| 96137 |
|
12 |
12 |
$874.51 |
| D7140 |
Extraction, erupted tooth or exposed root |
43 |
12 |
$834.02 |
| 95813 |
|
15 |
13 |
$810.57 |
| 69210 |
|
75 |
71 |
$799.25 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60 |
56 |
$734.55 |
| 73562 |
|
125 |
99 |
$711.97 |
| 96113 |
|
19 |
18 |
$704.46 |
| 99385 |
|
12 |
12 |
$701.86 |
| 00140 |
|
15 |
13 |
$671.42 |
| 43762 |
|
12 |
12 |
$643.89 |
| 00145 |
|
13 |
13 |
$634.20 |
| 99221 |
|
27 |
24 |
$568.77 |
| 96150 |
|
49 |
40 |
$564.46 |
| 99464 |
|
13 |
12 |
$555.72 |
| 99218 |
|
14 |
12 |
$539.73 |
| 97165 |
|
14 |
14 |
$521.35 |
| 31231 |
|
16 |
12 |
$514.28 |
| 64645 |
|
37 |
24 |
$497.87 |
| 76885 |
|
15 |
14 |
$496.52 |
| 99226 |
|
13 |
12 |
$476.94 |
| 73060 |
|
61 |
51 |
$434.90 |
| 00811 |
|
14 |
13 |
$433.25 |
| 92136 |
|
39 |
29 |
$419.99 |
| 92225 |
|
22 |
19 |
$418.94 |
| 99443 |
|
50 |
40 |
$410.70 |
| 76870 |
|
12 |
12 |
$402.51 |
| 73080 |
|
60 |
51 |
$397.13 |
| 97597 |
|
36 |
30 |
$370.36 |
| 99288 |
|
13 |
13 |
$367.82 |
| 92020 |
|
51 |
41 |
$324.04 |
| 87631 |
|
58 |
53 |
$320.00 |
| 96151 |
|
17 |
16 |
$301.81 |
| 93272 |
|
26 |
26 |
$293.69 |
| 95012 |
|
51 |
43 |
$292.94 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
17 |
15 |
$279.91 |
| 3008F |
|
31 |
28 |
$275.20 |
| 99358 |
Prolong nursin fac eval 15m |
628 |
571 |
$275.18 |
| 77089 |
|
29 |
19 |
$266.42 |
| 88311 |
|
30 |
25 |
$235.68 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$219.18 |
| 92567 |
|
23 |
14 |
$200.12 |
| 80235 |
|
38 |
27 |
$188.71 |
| 93926 |
|
26 |
24 |
$185.50 |
| 99152 |
|
15 |
13 |
$184.00 |
| 93880 |
|
13 |
13 |
$166.36 |
| 88302 |
|
24 |
12 |
$150.66 |
| 43760 |
|
13 |
13 |
$149.99 |
| 72190 |
|
15 |
13 |
$147.35 |
| 73660 |
|
24 |
24 |
$138.45 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
44 |
22 |
$113.04 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
41 |
40 |
$93.14 |
| 99442 |
|
30 |
25 |
$90.22 |
| 80143 |
|
86 |
66 |
$89.46 |
| 80179 |
|
70 |
59 |
$74.55 |
| 93294 |
|
14 |
14 |
$66.72 |
| 99407 |
|
59 |
53 |
$49.48 |
| 83655 |
|
339 |
325 |
$38.75 |
| 80202 |
|
44 |
27 |
$28.02 |
| 96040 |
|
522 |
492 |
$9.41 |
| 99359 |
Prolong nursin fac eval 15m |
59 |
42 |
$0.00 |
| V5008 |
Hearing screening |
198 |
181 |
$0.00 |
| 98943 |
|
147 |
79 |
$0.00 |
| 82024 |
|
58 |
43 |
$0.00 |
| 84540 |
|
15 |
12 |
$0.00 |
| 94760 |
|
15 |
14 |
$0.00 |
| 86364 |
|
140 |
136 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
12 |
$0.00 |