| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,678 |
4,146 |
$161K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,083 |
4,574 |
$153K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,491 |
1,447 |
$72K |
| 97803 |
|
1,125 |
991 |
$44K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,012 |
3,864 |
$40K |
| 80061 |
Lipid panel |
4,068 |
3,966 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
493 |
480 |
$30K |
| 80053 |
Comprehensive metabolic panel |
4,461 |
4,187 |
$27K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
272 |
253 |
$24K |
| 36415 |
Collection of venous blood by venipuncture |
9,728 |
8,481 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,368 |
2,275 |
$23K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
274 |
261 |
$22K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,146 |
3,700 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
325 |
309 |
$17K |
| 0002A |
|
1,254 |
1,000 |
$15K |
| 0001A |
|
1,361 |
1,059 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
342 |
333 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
504 |
487 |
$10K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
45 |
44 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
820 |
796 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,646 |
1,396 |
$8K |
| 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 |
63 |
59 |
$6K |
| 76642 |
|
111 |
104 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
89 |
$6K |
| X5622 |
|
1,026 |
1,000 |
$6K |
| 84439 |
|
855 |
809 |
$5K |
| 97802 |
|
50 |
50 |
$4K |
| 82728 |
|
427 |
408 |
$3K |
| 99188 |
|
693 |
687 |
$3K |
| 85027 |
|
727 |
609 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
588 |
576 |
$3K |
| 90686 |
|
922 |
900 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
227 |
222 |
$2K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
71 |
67 |
$2K |
| 82043 |
|
790 |
780 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
86 |
85 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
400 |
393 |
$2K |
| 96127 |
|
473 |
459 |
$2K |
| 92551 |
|
330 |
326 |
$2K |
| 77066 |
Tomosynthesis, mammo |
16 |
15 |
$2K |
| 80306 |
|
115 |
93 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
107 |
101 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 99215 |
Prolong outpt/office vis |
116 |
114 |
$910.87 |
| 80076 |
|
209 |
200 |
$745.86 |
| 80050 |
General health panel |
25 |
24 |
$649.20 |
| 81025 |
|
73 |
69 |
$637.44 |
| 99000 |
|
131 |
125 |
$563.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
87 |
77 |
$550.25 |
| 83550 |
|
111 |
106 |
$549.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$504.53 |
| 90715 |
|
38 |
38 |
$478.40 |
| 85610 |
|
228 |
168 |
$449.71 |
| 99442 |
|
20 |
12 |
$429.24 |
| 83540 |
|
124 |
120 |
$413.64 |
| 81001 |
|
284 |
268 |
$402.91 |
| 99173 |
|
348 |
342 |
$353.83 |
| 99421 |
|
14 |
14 |
$335.34 |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
12 |
12 |
$316.37 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
12 |
$258.36 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
45 |
44 |
$254.20 |
| 86850 |
|
31 |
30 |
$252.77 |
| 90670 |
|
186 |
181 |
$206.17 |
| 82947 |
|
54 |
54 |
$190.09 |
| 86780 |
|
12 |
12 |
$166.37 |
| 87340 |
|
13 |
13 |
$141.44 |
| 85018 |
|
97 |
95 |
$140.20 |
| 82950 |
|
26 |
26 |
$130.52 |
| 80197 |
|
21 |
12 |
$130.07 |
| 90734 |
|
14 |
14 |
$109.78 |
| 86900 |
|
33 |
31 |
$99.09 |
| 86140 |
|
59 |
58 |
$99.05 |
| 86901 |
|
32 |
31 |
$88.76 |
| 84460 |
|
66 |
65 |
$79.09 |
| 96161 |
|
48 |
45 |
$73.79 |
| 82565 |
|
65 |
63 |
$64.53 |
| 92015 |
Determination of refractive state |
59 |
58 |
$39.75 |
| 85652 |
|
57 |
57 |
$31.72 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12 |
12 |
$31.48 |
| 84703 |
|
14 |
13 |
$9.83 |
| 90698 |
|
104 |
100 |
$0.00 |
| 90651 |
|
25 |
25 |
$0.00 |
| 36416 |
|
15 |
13 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
22 |
12 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
26 |
15 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
12 |
$0.00 |
| 90685 |
|
77 |
76 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 91300 |
|
62 |
41 |
$0.00 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
17 |
12 |
$0.00 |