| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60,998 |
56,030 |
$3.97M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
88,621 |
78,372 |
$3.21M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
18,361 |
16,726 |
$927K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,234 |
10,944 |
$840K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,921 |
11,305 |
$575K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
3,756 |
3,736 |
$352K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,722 |
8,469 |
$332K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,005 |
3,986 |
$326K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,527 |
8,465 |
$305K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
8,213 |
8,171 |
$304K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
6,292 |
6,255 |
$262K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,841 |
3,828 |
$243K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,553 |
2,540 |
$238K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,153 |
1,103 |
$126K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,130 |
2,115 |
$120K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,190 |
8,965 |
$107K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,457 |
3,724 |
$87K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21,382 |
21,118 |
$85K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
3,498 |
2,920 |
$85K |
| 99381 |
|
1,139 |
1,138 |
$81K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
645 |
642 |
$61K |
| 99215 |
Prolong outpt/office vis |
793 |
763 |
$57K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
10,957 |
10,877 |
$54K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,336 |
5,688 |
$54K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,274 |
2,266 |
$53K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,633 |
803 |
$53K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,551 |
7,511 |
$47K |
| 99222 |
Initial hospital care, per day, moderate complexity |
666 |
639 |
$41K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
779 |
616 |
$40K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
859 |
839 |
$40K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
8,961 |
7,858 |
$38K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,463 |
4,408 |
$29K |
| 99000 |
|
3,019 |
2,912 |
$27K |
| 99223 |
Prolong inpt eval add15 m |
294 |
271 |
$26K |
| 96127 |
|
10,075 |
7,935 |
$26K |
| 90686 |
|
5,299 |
5,288 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,023 |
975 |
$22K |
| 81025 |
|
3,547 |
3,467 |
$22K |
| 90715 |
|
2,223 |
2,219 |
$22K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,131 |
649 |
$21K |
| 17110 |
|
522 |
484 |
$21K |
| 81003 |
|
12,837 |
12,271 |
$20K |
| 99051 |
|
6,424 |
6,262 |
$20K |
| 99254 |
|
210 |
202 |
$20K |
| 93000 |
|
1,862 |
1,837 |
$15K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
460 |
446 |
$15K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
1,403 |
1,343 |
$14K |
| 10060 |
|
204 |
202 |
$11K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
80 |
80 |
$11K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
113 |
112 |
$11K |
| 90651 |
|
2,352 |
2,347 |
$9K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
157 |
118 |
$9K |
| 99460 |
|
179 |
179 |
$8K |
| 99463 |
|
153 |
153 |
$8K |
| 99441 |
|
516 |
493 |
$8K |
| 12001 |
|
271 |
268 |
$8K |
| 99306 |
Prolong nursin fac eval 15m |
97 |
85 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,204 |
1,157 |
$6K |
| 99442 |
|
265 |
260 |
$6K |
| 90670 |
|
5,751 |
5,738 |
$5K |
| 90474 |
|
3,303 |
3,279 |
$5K |
| 36416 |
|
1,261 |
1,239 |
$4K |
| 99383 |
|
82 |
81 |
$4K |
| 92558 |
|
2,309 |
2,288 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
195 |
182 |
$3K |
| 99406 |
|
400 |
388 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,584 |
1,484 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
908 |
882 |
$2K |
| 12002 |
|
64 |
64 |
$2K |
| 99382 |
|
37 |
37 |
$2K |
| 99307 |
|
127 |
112 |
$2K |
| 99233 |
Prolong inpt eval add15 m |
30 |
12 |
$2K |
| 82044 |
|
419 |
417 |
$2K |
| 90734 |
|
2,025 |
2,016 |
$1K |
| 85018 |
|
1,568 |
1,554 |
$1K |
| 90656 |
|
150 |
150 |
$1K |
| 0012A |
|
34 |
34 |
$1K |
| 99310 |
Prolong nursin fac eval 15m |
12 |
12 |
$1K |
| 86308 |
|
313 |
313 |
$1K |
| 95117 |
|
473 |
191 |
$1K |
| 17250 |
|
25 |
24 |
$1K |
| 0011A |
|
36 |
36 |
$1K |
| 94010 |
|
59 |
58 |
$1K |
| 90632 |
|
15 |
15 |
$877.65 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
585 |
522 |
$868.84 |
| 90707 |
|
1,489 |
1,488 |
$866.27 |
| 12011 |
|
24 |
24 |
$782.38 |
| 99174 |
|
2,229 |
2,225 |
$725.53 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
17 |
$690.70 |
| 29125 |
|
30 |
30 |
$676.05 |
| 99384 |
|
14 |
14 |
$596.22 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
412 |
404 |
$582.60 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
26 |
26 |
$574.28 |
| 69209 |
|
56 |
54 |
$549.47 |
| 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) |
848 |
823 |
$526.67 |
| 99217 |
|
12 |
12 |
$492.12 |
| 99316 |
|
15 |
12 |
$478.55 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
89 |
86 |
$439.91 |
| 90621 |
|
600 |
595 |
$403.58 |
| 29515 |
|
12 |
12 |
$352.44 |
| 96160 |
|
15 |
15 |
$315.27 |
| 90714 |
|
13 |
13 |
$300.95 |
| 90677 |
|
217 |
217 |
$298.04 |
| G0008 |
Administration of influenza virus vaccine |
214 |
207 |
$248.98 |
| 90716 |
|
1,476 |
1,475 |
$224.36 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
20 |
20 |
$168.44 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
24 |
24 |
$136.34 |
| 82962 |
|
56 |
56 |
$116.62 |
| 3008F |
|
81,740 |
73,680 |
$100.55 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$87.14 |
| 3074F |
|
70,342 |
63,293 |
$78.01 |
| 3078F |
|
58,263 |
52,992 |
$65.29 |
| 3079F |
|
25,415 |
23,952 |
$40.97 |
| 90461 |
|
1,404 |
1,404 |
$33.50 |
| 3075F |
|
11,258 |
10,801 |
$26.10 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
86 |
85 |
$18.65 |
| 3077F |
|
7,659 |
7,239 |
$9.49 |
| 99053 |
|
3,400 |
3,151 |
$8.75 |
| 3080F |
|
5,544 |
5,319 |
$7.18 |
| 1034F |
|
10,274 |
9,232 |
$7.03 |
| 2010F |
|
12,768 |
11,411 |
$3.25 |
| 2000F |
|
2,162 |
2,035 |
$2.20 |
| 1033F |
|
377 |
368 |
$1.06 |
| 3051F |
|
266 |
265 |
$0.60 |
| 1005F |
|
98 |
98 |
$0.19 |
| 3052F |
|
59 |
59 |
$0.18 |
| 1032F |
|
41 |
41 |
$0.16 |
| G9002 |
Coordinated care fee, maintenance rate |
361 |
347 |
$0.09 |
| 1000F |
|
16 |
16 |
$0.05 |
| G8421 |
Bmi not documented and no reason is given |
470 |
457 |
$0.01 |
| 3045F |
|
240 |
232 |
$0.00 |
| 90685 |
|
418 |
416 |
$0.00 |
| 4004F |
|
2,975 |
2,607 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
729 |
684 |
$0.00 |
| 90648 |
|
745 |
743 |
$0.00 |
| 90700 |
|
1,018 |
1,015 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
4,674 |
4,301 |
$0.00 |
| 3046F |
|
332 |
327 |
$0.00 |
| 99173 |
|
989 |
988 |
$0.00 |
| 90633 |
|
3,946 |
3,931 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
232 |
224 |
$0.00 |
| 90710 |
|
1,016 |
1,011 |
$0.00 |
| 4120F |
|
1,169 |
1,142 |
$0.00 |
| G9001 |
Coordinated care fee, initial rate |
153 |
153 |
$0.00 |
| 90662 |
|
30 |
30 |
$0.00 |
| 3016F |
|
94 |
93 |
$0.00 |
| 99072 |
|
437 |
430 |
$0.00 |
| 90713 |
|
18 |
18 |
$0.00 |
| 3288F |
|
14 |
13 |
$0.00 |
| 90671 |
|
12 |
12 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
940 |
928 |
$0.00 |
| 90680 |
|
3,615 |
3,609 |
$0.00 |
| 90698 |
|
4,690 |
4,681 |
$0.00 |
| 90744 |
|
2,876 |
2,870 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
2,137 |
1,937 |
$0.00 |
| 90696 |
|
1,137 |
1,133 |
$0.00 |
| G9007 |
Coordinated care fee, scheduled team conference |
112 |
109 |
$0.00 |
| 1036F |
|
24,144 |
21,661 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
5,203 |
4,766 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,691 |
1,650 |
$0.00 |
| 3044F |
|
2,208 |
2,193 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
3,796 |
3,444 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
126 |
121 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
771 |
734 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
97 |
97 |
$0.00 |
| 1111F |
|
217 |
207 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
122 |
115 |
$0.00 |
| G8433 |
Screening for depression not completed, documented patient or medical reason |
58 |
54 |
$0.00 |
| 90619 |
|
310 |
310 |
$0.00 |
| 1038F |
|
52 |
49 |
$0.00 |
| 94760 |
|
16 |
15 |
$0.00 |
| 90688 |
|
79 |
79 |
$0.00 |
| 91301 |
|
13 |
12 |
$0.00 |