| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
148,338 |
125,089 |
$8.35M |
| 99199 |
Unlisted special service, procedure or report |
915,660 |
425,349 |
$5.37M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
83,512 |
69,351 |
$4.33M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17,868 |
15,624 |
$1.60M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16,620 |
13,697 |
$1.37M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12,617 |
11,034 |
$1.19M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45,514 |
39,512 |
$840K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
24,561 |
21,933 |
$761K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,238 |
4,456 |
$528K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
14,035 |
12,054 |
$463K |
| D0145 |
Oral evaluation for a patient under three years of age |
9,432 |
8,723 |
$315K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,762 |
686 |
$304K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
9,119 |
3,874 |
$225K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17,559 |
15,698 |
$145K |
| D1206 |
Topical application of fluoride varnish |
9,401 |
8,667 |
$138K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,409 |
901 |
$128K |
| 99051 |
|
5,496 |
4,443 |
$119K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,306 |
1,063 |
$111K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,715 |
2,262 |
$96K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,833 |
2,001 |
$87K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,587 |
5,488 |
$82K |
| 99215 |
Prolong outpt/office vis |
1,488 |
1,290 |
$79K |
| 99233 |
Prolong inpt eval add15 m |
2,762 |
774 |
$65K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
805 |
754 |
$63K |
| 87400 |
|
4,468 |
2,754 |
$62K |
| 90961 |
|
1,840 |
1,583 |
$55K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,197 |
1,687 |
$54K |
| 90474 |
|
2,750 |
2,532 |
$53K |
| 95886 |
|
917 |
833 |
$41K |
| 99442 |
|
774 |
619 |
$38K |
| 99205 |
Prolong outpt/office vis |
371 |
322 |
$36K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
215 |
194 |
$31K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,573 |
1,309 |
$31K |
| 95911 |
|
296 |
266 |
$30K |
| 90686 |
|
12,415 |
10,451 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
435 |
388 |
$26K |
| 95251 |
|
2,630 |
2,142 |
$26K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
675 |
538 |
$25K |
| 99443 |
|
342 |
271 |
$21K |
| 90791 |
Psychiatric diagnostic evaluation |
190 |
138 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,256 |
2,462 |
$19K |
| 94729 |
|
1,993 |
1,805 |
$19K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
199 |
148 |
$18K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
318 |
244 |
$17K |
| 64405 |
|
330 |
259 |
$16K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
1,382 |
831 |
$16K |
| 94060 |
|
856 |
773 |
$16K |
| 94727 |
|
1,931 |
1,748 |
$15K |
| 36415 |
Collection of venous blood by venipuncture |
6,033 |
5,287 |
$15K |
| 95811 |
|
165 |
158 |
$14K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
289 |
256 |
$13K |
| 81003 |
|
4,659 |
3,758 |
$12K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,235 |
1,092 |
$11K |
| 80053 |
Comprehensive metabolic panel |
1,144 |
1,042 |
$11K |
| 85018 |
|
3,747 |
2,878 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
632 |
517 |
$10K |
| 96127 |
|
2,475 |
2,179 |
$10K |
| 92567 |
|
765 |
670 |
$9K |
| 43235 |
|
194 |
154 |
$9K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
104 |
92 |
$8K |
| 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) |
3,128 |
2,690 |
$8K |
| J2785 |
Injection, regadenoson, 0.1 mg |
215 |
188 |
$7K |
| 94010 |
|
635 |
576 |
$6K |
| 92551 |
|
24,930 |
22,494 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
354 |
330 |
$6K |
| 90651 |
|
819 |
756 |
$6K |
| 90734 |
|
354 |
282 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
460 |
412 |
$5K |
| 93015 |
|
139 |
133 |
$5K |
| 86756 |
|
311 |
225 |
$4K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
90 |
62 |
$4K |
| 96161 |
|
1,379 |
1,084 |
$4K |
| 90656 |
|
949 |
863 |
$4K |
| 80061 |
Lipid panel |
267 |
236 |
$4K |
| 73130 |
|
311 |
189 |
$3K |
| 93000 |
|
377 |
359 |
$3K |
| 93793 |
|
981 |
643 |
$3K |
| 99441 |
|
157 |
102 |
$3K |
| 93016 |
|
418 |
346 |
$3K |
| 99173 |
|
24,694 |
22,233 |
$3K |
| 76536 |
|
103 |
87 |
$3K |
| 73630 |
|
240 |
137 |
$3K |
| 73564 |
|
168 |
95 |
$2K |
| 99222 |
Initial hospital care, per day, moderate complexity |
166 |
145 |
$2K |
| 99490 |
Ccm add 20min |
178 |
176 |
$2K |
| 71250 |
|
31 |
25 |
$2K |
| Q5106 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
29 |
12 |
$2K |
| 90962 |
|
92 |
73 |
$2K |
| 84439 |
|
152 |
143 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
36 |
20 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
548 |
491 |
$1K |
| 80074 |
|
27 |
26 |
$1K |
| 90619 |
|
259 |
237 |
$1K |
| 99381 |
|
13 |
13 |
$1K |
| 99223 |
Prolong inpt eval add15 m |
46 |
43 |
$1K |
| 90620 |
|
97 |
77 |
$1K |
| 85610 |
|
962 |
631 |
$968.86 |
| 95910 |
|
13 |
12 |
$962.10 |
| 90670 |
|
10,253 |
9,232 |
$899.42 |
| 99401 |
|
43 |
28 |
$878.98 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
25 |
24 |
$848.47 |
| 86140 |
|
147 |
137 |
$846.71 |
| 69210 |
|
28 |
25 |
$845.56 |
| 17110 |
|
17 |
12 |
$845.45 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
81 |
79 |
$777.74 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
27 |
27 |
$756.56 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$743.76 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
83 |
37 |
$732.54 |
| 72110 |
|
29 |
28 |
$669.31 |
| 85651 |
|
177 |
157 |
$663.17 |
| 43248 |
|
17 |
13 |
$626.76 |
| 99406 |
|
190 |
120 |
$625.02 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
57 |
55 |
$597.07 |
| 90633 |
|
3,422 |
3,081 |
$568.54 |
| 90715 |
|
123 |
111 |
$564.45 |
| 82948 |
|
284 |
243 |
$469.52 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
51 |
37 |
$369.52 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
47 |
27 |
$311.57 |
| 90723 |
|
6,706 |
6,091 |
$281.86 |
| 82607 |
|
16 |
16 |
$281.70 |
| 73030 |
|
20 |
13 |
$252.57 |
| 93017 |
|
21 |
15 |
$232.38 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
560 |
503 |
$228.48 |
| 87420 |
|
19 |
12 |
$223.80 |
| 99221 |
|
13 |
13 |
$199.49 |
| 71046 |
Radiologic examination, chest; 2 views |
14 |
14 |
$190.94 |
| 90966 |
|
19 |
12 |
$178.72 |
| 90970 |
|
227 |
84 |
$174.57 |
| 90681 |
|
2,727 |
2,510 |
$136.57 |
| 90662 |
|
261 |
234 |
$116.95 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
1,336 |
1,156 |
$104.65 |
| 85027 |
|
15 |
13 |
$98.02 |
| 94760 |
|
90 |
86 |
$57.96 |
| 90647 |
|
6,733 |
6,077 |
$55.13 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
63 |
60 |
$48.80 |
| 86580 |
|
12 |
12 |
$37.75 |
| G0296 |
Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) |
71 |
52 |
$33.27 |
| 90688 |
|
16 |
13 |
$16.67 |
| 94664 |
|
15 |
14 |
$11.13 |
| 90677 |
|
402 |
393 |
$0.38 |
| 90716 |
|
189 |
180 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
4,480 |
3,701 |
$0.00 |
| 90696 |
|
264 |
227 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
1,041 |
907 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
57 |
55 |
$0.00 |
| 90680 |
|
14 |
13 |
$0.00 |
| 90700 |
|
137 |
124 |
$0.00 |
| 90685 |
|
781 |
762 |
$0.00 |
| 90710 |
|
261 |
224 |
$0.00 |
| 90707 |
|
165 |
163 |
$0.00 |
| 99497 |
|
69 |
58 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
47 |
43 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
16 |
12 |
$0.00 |