| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
62,395 |
56,092 |
$4.04M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
63,199 |
60,629 |
$3.00M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
68,414 |
61,680 |
$2.85M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74,137 |
69,328 |
$2.24M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
16,593 |
14,642 |
$1.59M |
| H1000 |
Prenatal care, at-risk assessment |
18,431 |
15,463 |
$917K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12,839 |
12,066 |
$840K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
26,092 |
9,494 |
$826K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
8,336 |
7,623 |
$777K |
| 99223 |
Prolong inpt eval add15 m |
4,691 |
4,152 |
$553K |
| 87428 |
|
15,531 |
14,419 |
$478K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
5,708 |
5,180 |
$455K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
3,912 |
3,701 |
$424K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
4,932 |
1,875 |
$417K |
| 99233 |
Prolong inpt eval add15 m |
9,022 |
3,572 |
$406K |
| 99157 |
|
2,237 |
1,911 |
$380K |
| 99460 |
|
7,015 |
6,605 |
$363K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
8,300 |
7,814 |
$349K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
3,983 |
3,760 |
$328K |
| 99222 |
Initial hospital care, per day, moderate complexity |
3,228 |
2,926 |
$320K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
885 |
805 |
$285K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,691 |
9,477 |
$279K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,580 |
5,051 |
$272K |
| 99215 |
Prolong outpt/office vis |
3,223 |
2,765 |
$189K |
| 99205 |
Prolong outpt/office vis |
1,254 |
1,100 |
$166K |
| 99243 |
|
2,712 |
2,500 |
$160K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
29,391 |
24,989 |
$122K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
2,033 |
1,220 |
$117K |
| 59410 |
|
91 |
90 |
$109K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
509 |
491 |
$99K |
| 99254 |
|
880 |
783 |
$87K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
277 |
268 |
$82K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
812 |
798 |
$81K |
| 95117 |
|
6,790 |
3,712 |
$73K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,142 |
1,044 |
$65K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
599 |
477 |
$65K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,094 |
8,080 |
$58K |
| 99245 |
|
472 |
416 |
$53K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
767 |
727 |
$47K |
| 99155 |
|
752 |
697 |
$43K |
| 99156 |
|
772 |
701 |
$41K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
535 |
501 |
$40K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
502 |
466 |
$34K |
| 95782 |
|
301 |
295 |
$31K |
| 81003 |
|
14,449 |
12,820 |
$30K |
| 93308 |
|
789 |
713 |
$26K |
| 99220 |
|
278 |
244 |
$24K |
| 95115 |
|
2,238 |
1,210 |
$20K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
473 |
460 |
$19K |
| 20610 |
|
636 |
469 |
$16K |
| 59430 |
|
342 |
319 |
$16K |
| 99242 |
|
345 |
321 |
$14K |
| 59515 |
|
12 |
12 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
489 |
466 |
$12K |
| 99255 |
|
118 |
97 |
$12K |
| 0002A |
|
283 |
269 |
$10K |
| 99471 |
|
12 |
12 |
$10K |
| 95720 |
|
44 |
26 |
$10K |
| 94010 |
|
576 |
554 |
$9K |
| 93321 |
|
1,489 |
1,362 |
$8K |
| 93000 |
|
831 |
781 |
$8K |
| 0001A |
|
227 |
212 |
$8K |
| 95886 |
|
426 |
242 |
$8K |
| 93304 |
|
164 |
142 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
121 |
121 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
80 |
78 |
$7K |
| 95816 |
|
141 |
136 |
$7K |
| H2000 |
Comprehensive multidisciplinary evaluation |
41 |
32 |
$7K |
| 99463 |
|
101 |
98 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
477 |
386 |
$6K |
| 93325 |
|
2,445 |
2,220 |
$6K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
308 |
120 |
$6K |
| 81025 |
|
452 |
422 |
$6K |
| 90837 |
Psychotherapy, 53 minutes with patient |
52 |
42 |
$5K |
| 99462 |
|
272 |
223 |
$5K |
| 96401 |
|
74 |
56 |
$5K |
| 99454 |
|
267 |
247 |
$5K |
| 99349 |
|
200 |
147 |
$4K |
| 93320 |
|
507 |
474 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
62 |
62 |
$4K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
38 |
36 |
$4K |
| 54161 |
|
26 |
26 |
$4K |
| 76801 |
|
41 |
39 |
$3K |
| 95170 |
|
304 |
192 |
$3K |
| 42830 |
|
26 |
26 |
$3K |
| 92015 |
Determination of refractive state |
240 |
238 |
$3K |
| 99253 |
|
49 |
40 |
$3K |
| 94060 |
|
133 |
124 |
$3K |
| 3078F |
|
36,942 |
26,479 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
39 |
39 |
$3K |
| 64615 |
|
26 |
25 |
$3K |
| 31231 |
|
17 |
16 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
601 |
574 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
378 |
330 |
$2K |
| 99457 |
|
214 |
198 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
62 |
48 |
$2K |
| 99221 |
|
27 |
27 |
$2K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
381 |
345 |
$2K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$2K |
| 51741 |
|
155 |
143 |
$2K |
| 59025 |
Fetal non-stress test |
34 |
25 |
$2K |
| 99217 |
|
38 |
37 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
145 |
139 |
$2K |
| 76825 |
|
28 |
26 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
115 |
96 |
$2K |
| 51798 |
|
514 |
467 |
$1K |
| H0031 |
Mental health assessment, by non-physician |
12 |
12 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
38 |
38 |
$1K |
| 95811 |
|
13 |
12 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
19 |
19 |
$1K |
| 82962 |
|
712 |
629 |
$1K |
| 0012A |
|
64 |
55 |
$1K |
| 99385 |
|
13 |
13 |
$1K |
| 3080F |
|
104 |
66 |
$1K |
| 94729 |
|
169 |
160 |
$1K |
| 0064A |
|
116 |
81 |
$892.25 |
| 94727 |
|
157 |
149 |
$841.81 |
| 99458 |
|
46 |
45 |
$784.95 |
| 90715 |
|
43 |
37 |
$758.74 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
36 |
25 |
$738.27 |
| 27096 |
|
17 |
12 |
$725.99 |
| 93244 |
|
28 |
26 |
$678.28 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
178 |
164 |
$660.53 |
| 92060 |
|
69 |
69 |
$453.92 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
12 |
$449.09 |
| 0011A |
|
21 |
18 |
$444.00 |
| 3079F |
|
2,448 |
1,728 |
$440.10 |
| 99153 |
Mod sedat endo service >5yrs |
26 |
22 |
$418.60 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
56 |
41 |
$356.25 |
| 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) |
1,618 |
1,482 |
$347.76 |
| 1000F |
|
25,732 |
19,640 |
$308.54 |
| 99151 |
|
16 |
14 |
$257.86 |
| 0004A |
|
18 |
15 |
$248.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$239.29 |
| 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) |
43 |
25 |
$212.00 |
| 0013A |
|
17 |
12 |
$200.75 |
| 99453 |
|
63 |
56 |
$168.22 |
| 93016 |
|
13 |
12 |
$158.83 |
| 95885 |
|
15 |
12 |
$137.65 |
| 76827 |
|
28 |
26 |
$136.69 |
| 3074F |
|
35,326 |
32,268 |
$125.00 |
| 99152 |
|
17 |
15 |
$122.86 |
| 76376 |
|
35 |
28 |
$120.44 |
| 36415 |
Collection of venous blood by venipuncture |
55 |
46 |
$120.00 |
| 77002 |
|
19 |
13 |
$92.11 |
| 80053 |
Comprehensive metabolic panel |
13 |
13 |
$80.36 |
| 92201 |
|
68 |
43 |
$79.98 |
| 93018 |
|
13 |
12 |
$65.18 |
| 99406 |
|
16 |
12 |
$60.78 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,220 |
918 |
$51.25 |
| 85018 |
|
44 |
42 |
$28.74 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
14 |
12 |
$25.10 |
| 90656 |
|
48 |
47 |
$12.00 |
| 1036F |
|
14,920 |
11,637 |
$0.00 |
| 3017F |
|
783 |
634 |
$0.00 |
| 4037F |
|
181 |
159 |
$0.00 |
| 92551 |
|
72 |
40 |
$0.00 |
| 3075F |
|
354 |
341 |
$0.00 |
| 36416 |
|
186 |
165 |
$0.00 |
| 1034F |
|
74 |
50 |
$0.00 |
| 92250 |
|
17 |
13 |
$0.00 |
| 1125F |
|
33 |
28 |
$0.00 |
| 99495 |
|
13 |
12 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
7,830 |
7,017 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
27,095 |
24,220 |
$0.00 |
| 3077F |
|
488 |
339 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
183 |
128 |
$0.00 |
| 91300 |
|
59 |
49 |
$0.00 |
| 92202 |
|
20 |
20 |
$0.00 |
| 99173 |
|
72 |
40 |
$0.00 |
| 95251 |
|
32 |
31 |
$0.00 |
| 1159F |
|
32 |
25 |
$0.00 |