| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31,376 |
24,431 |
$1.70M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
13,751 |
10,875 |
$882K |
| 99199 |
Unlisted special service, procedure or report |
63,157 |
33,496 |
$443K |
| G0481 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed |
4,054 |
3,068 |
$414K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,243 |
8,331 |
$391K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
5,814 |
4,982 |
$372K |
| 83970 |
|
1,956 |
1,646 |
$85K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,140 |
1,795 |
$67K |
| 99406 |
|
9,058 |
6,947 |
$64K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
889 |
646 |
$57K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
815 |
582 |
$56K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
493 |
435 |
$37K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
458 |
325 |
$36K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,062 |
768 |
$33K |
| 86769 |
|
818 |
769 |
$32K |
| 80053 |
Comprehensive metabolic panel |
3,299 |
2,897 |
$30K |
| 94375 |
|
1,668 |
1,363 |
$29K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
511 |
374 |
$28K |
| 99443 |
|
415 |
291 |
$27K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,703 |
1,783 |
$27K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,372 |
2,924 |
$27K |
| 80061 |
Lipid panel |
1,754 |
1,551 |
$25K |
| 81025 |
|
3,631 |
2,898 |
$22K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,134 |
1,015 |
$19K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
887 |
646 |
$19K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,959 |
1,595 |
$18K |
| 82607 |
|
1,154 |
948 |
$18K |
| 82746 |
|
1,130 |
924 |
$17K |
| 82728 |
|
1,165 |
952 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
8,620 |
6,807 |
$14K |
| 84480 |
|
971 |
833 |
$14K |
| 93000 |
|
1,224 |
1,029 |
$13K |
| 99442 |
|
350 |
225 |
$12K |
| 71046 |
Radiologic examination, chest; 2 views |
716 |
581 |
$11K |
| 83550 |
|
1,163 |
952 |
$10K |
| 99401 |
|
410 |
301 |
$9K |
| 84439 |
|
991 |
849 |
$9K |
| 80050 |
General health panel |
682 |
602 |
$7K |
| 86703 |
|
409 |
368 |
$5K |
| 83540 |
|
579 |
445 |
$4K |
| 72100 |
|
236 |
196 |
$4K |
| 82962 |
|
2,316 |
1,680 |
$4K |
| 86803 |
|
218 |
197 |
$3K |
| 17110 |
|
48 |
39 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
290 |
240 |
$2K |
| 87340 |
|
230 |
207 |
$2K |
| 83735 |
|
245 |
223 |
$2K |
| 81002 |
|
1,500 |
1,186 |
$1K |
| 90756 |
|
104 |
84 |
$1K |
| 90688 |
|
111 |
87 |
$995.95 |
| 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) |
355 |
294 |
$767.40 |
| 90661 |
|
44 |
40 |
$653.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$615.72 |
| 72050 |
|
19 |
16 |
$400.32 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
396 |
276 |
$292.12 |
| 72070 |
|
14 |
13 |
$268.23 |
| 86431 |
|
41 |
39 |
$267.05 |
| G2011 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes |
93 |
68 |
$219.38 |
| 82044 |
|
132 |
110 |
$206.72 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
73 |
51 |
$188.14 |
| 3044F |
|
1,793 |
1,560 |
$160.00 |
| 96146 |
|
204 |
98 |
$154.85 |
| 84550 |
|
29 |
27 |
$145.67 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
284 |
245 |
$96.38 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
169 |
147 |
$96.14 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
346 |
239 |
$52.41 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
21 |
16 |
$34.54 |
| 3008F |
|
27,162 |
22,077 |
$33.97 |
| 96160 |
|
67 |
61 |
$26.51 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
825 |
553 |
$3.07 |
| 4004F |
|
4,786 |
3,960 |
$0.00 |
| 3078F |
|
11,726 |
9,906 |
$0.00 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
166 |
146 |
$0.00 |
| 3077F |
|
1,325 |
1,127 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
142 |
123 |
$0.00 |
| 1159F |
|
133 |
110 |
$0.00 |
| 80348 |
|
16 |
13 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
157 |
137 |
$0.00 |
| 92546 |
|
22 |
12 |
$0.00 |
| 92547 |
|
16 |
12 |
$0.00 |
| 3079F |
|
3,057 |
2,615 |
$0.00 |
| 3074F |
|
11,877 |
9,997 |
$0.00 |
| 3048F |
|
597 |
518 |
$0.00 |
| 3080F |
|
151 |
128 |
$0.00 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
138 |
109 |
$0.00 |
| 3075F |
|
1,227 |
1,087 |
$0.00 |
| G8839 |
Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness |
110 |
89 |
$0.00 |
| 1125F |
|
972 |
848 |
$0.00 |
| 3049F |
|
128 |
114 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
188 |
165 |
$0.00 |
| 4010F |
|
36 |
30 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
132 |
112 |
$0.00 |
| 1170F |
|
100 |
83 |
$0.00 |
| 3060F |
|
24 |
18 |
$0.00 |