| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
78,448 |
68,208 |
$4.52M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35,597 |
30,273 |
$2.77M |
| 99199 |
Unlisted special service, procedure or report |
424,112 |
241,130 |
$2.59M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
11,557 |
9,499 |
$964K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,653 |
9,493 |
$925K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,291 |
8,230 |
$834K |
| 87428 |
|
13,466 |
11,345 |
$791K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16,379 |
14,402 |
$640K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29,799 |
26,165 |
$562K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,735 |
3,207 |
$354K |
| D0145 |
Oral evaluation for a patient under three years of age |
8,417 |
7,520 |
$279K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
7,681 |
5,866 |
$255K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19,010 |
8,402 |
$251K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17,470 |
15,221 |
$231K |
| 99401 |
|
7,451 |
5,317 |
$211K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16,496 |
14,694 |
$151K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,379 |
4,046 |
$143K |
| D1206 |
Topical application of fluoride varnish |
8,408 |
7,504 |
$123K |
| 92552 |
|
13,476 |
12,076 |
$95K |
| 90474 |
|
4,396 |
3,952 |
$86K |
| 99051 |
|
3,135 |
2,800 |
$74K |
| 80061 |
Lipid panel |
3,890 |
3,460 |
$57K |
| 96127 |
|
8,655 |
7,493 |
$38K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,082 |
831 |
$38K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,435 |
2,183 |
$37K |
| 99490 |
Ccm add 20min |
2,088 |
2,040 |
$25K |
| 90651 |
|
1,005 |
910 |
$25K |
| 85018 |
|
14,053 |
12,416 |
$24K |
| 80053 |
Comprehensive metabolic panel |
2,684 |
2,376 |
$24K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,185 |
1,922 |
$20K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,525 |
2,234 |
$19K |
| 84439 |
|
1,867 |
1,679 |
$17K |
| 99381 |
|
158 |
128 |
$15K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,197 |
730 |
$15K |
| 99173 |
|
13,773 |
12,312 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
121 |
115 |
$13K |
| 99215 |
Prolong outpt/office vis |
103 |
93 |
$11K |
| 96161 |
|
4,024 |
2,591 |
$11K |
| 99442 |
|
236 |
164 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
590 |
533 |
$8K |
| 99307 |
|
870 |
547 |
$8K |
| 90734 |
|
272 |
245 |
$5K |
| 90686 |
|
3,847 |
3,336 |
$4K |
| 90688 |
|
6,723 |
5,863 |
$3K |
| 87280 |
|
211 |
172 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
129 |
128 |
$1K |
| 99382 |
|
14 |
12 |
$1K |
| 81002 |
|
742 |
663 |
$1K |
| 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) |
448 |
426 |
$1K |
| 85027 |
|
183 |
173 |
$1K |
| 82043 |
|
151 |
147 |
$1K |
| 82570 |
|
153 |
148 |
$944.68 |
| 90619 |
|
165 |
141 |
$914.40 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
88 |
86 |
$801.13 |
| 90656 |
|
933 |
883 |
$622.51 |
| 90715 |
|
71 |
69 |
$527.85 |
| 99441 |
|
13 |
12 |
$353.93 |
| 96380 |
|
16 |
16 |
$274.24 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$231.42 |
| 90670 |
|
6,461 |
5,619 |
$213.80 |
| 97802 |
|
81 |
77 |
$190.87 |
| 90698 |
|
5,071 |
4,499 |
$126.87 |
| 98960 |
|
297 |
219 |
$126.12 |
| 86140 |
|
13 |
13 |
$87.10 |
| 90633 |
|
2,297 |
2,094 |
$65.74 |
| 80076 |
|
13 |
12 |
$59.28 |
| 1030F |
|
10,350 |
9,072 |
$13.52 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13,005 |
10,083 |
$0.00 |
| 90680 |
|
4,435 |
3,958 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
5,648 |
4,668 |
$0.00 |
| 90677 |
|
1,062 |
1,041 |
$0.00 |
| 3008F |
|
10,690 |
9,538 |
$0.00 |
| 90744 |
|
2,585 |
2,286 |
$0.00 |
| 90716 |
|
2,299 |
2,042 |
$0.00 |
| 3074F |
|
378 |
332 |
$0.00 |
| 90647 |
|
205 |
193 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
88 |
82 |
$0.00 |
| 3079F |
|
31 |
25 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
7,019 |
5,850 |
$0.00 |
| 90700 |
|
2,227 |
2,003 |
$0.00 |
| G8539 |
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
203 |
147 |
$0.00 |
| 1003F |
|
1,441 |
1,341 |
$0.00 |
| 90713 |
|
298 |
253 |
$0.00 |
| 90707 |
|
2,293 |
2,040 |
$0.00 |
| 90687 |
|
151 |
149 |
$0.00 |
| 90685 |
|
425 |
417 |
$0.00 |
| 3078F |
|
209 |
188 |
$0.00 |