| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
72,725 |
67,557 |
$5.27M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52,868 |
50,179 |
$3.19M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,923 |
8,663 |
$897K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,209 |
6,172 |
$631K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15,805 |
7,580 |
$309K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,981 |
2,970 |
$296K |
| 90461 |
|
3,696 |
3,305 |
$141K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
640 |
626 |
$72K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
629 |
627 |
$69K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
707 |
688 |
$45K |
| 36415 |
Collection of venous blood by venipuncture |
15,137 |
13,945 |
$43K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,167 |
1,158 |
$40K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,167 |
1,158 |
$40K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
24 |
24 |
$38K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
925 |
889 |
$28K |
| 99188 |
|
2,523 |
2,403 |
$27K |
| 99173 |
|
5,081 |
5,059 |
$20K |
| 90670 |
|
3,969 |
3,938 |
$19K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
202 |
202 |
$17K |
| 80053 |
Comprehensive metabolic panel |
2,208 |
2,126 |
$15K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,523 |
2,444 |
$15K |
| 90698 |
|
3,159 |
3,132 |
$14K |
| 90686 |
|
2,750 |
2,736 |
$14K |
| 99215 |
Prolong outpt/office vis |
132 |
129 |
$14K |
| 20552 |
|
616 |
563 |
$12K |
| 64405 |
|
237 |
215 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
303 |
303 |
$10K |
| 90680 |
|
2,022 |
2,004 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
140 |
140 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,068 |
1,061 |
$9K |
| 80061 |
Lipid panel |
842 |
809 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
893 |
866 |
$6K |
| 96127 |
|
1,594 |
1,471 |
$5K |
| 11721 |
|
515 |
485 |
$5K |
| 87634 |
|
77 |
77 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
104 |
104 |
$5K |
| 84443 |
Thyroid stimulating hormone (TSH) |
392 |
378 |
$4K |
| 90633 |
|
818 |
812 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
39 |
39 |
$4K |
| 80305 |
|
454 |
434 |
$4K |
| 90744 |
|
806 |
794 |
$4K |
| 99490 |
Ccm add 20min |
1,286 |
1,272 |
$3K |
| 20610 |
|
93 |
89 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
54 |
54 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
378 |
359 |
$3K |
| 72170 |
|
246 |
239 |
$3K |
| 92551 |
|
214 |
214 |
$2K |
| 11102 |
|
51 |
51 |
$2K |
| 99335 |
|
54 |
52 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
128 |
127 |
$2K |
| 90697 |
|
436 |
434 |
$2K |
| 76801 |
|
39 |
38 |
$2K |
| 17110 |
|
43 |
40 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
121 |
74 |
$2K |
| 90677 |
|
366 |
365 |
$2K |
| 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) |
197 |
189 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
74 |
74 |
$2K |
| 73630 |
|
138 |
119 |
$2K |
| D1206 |
Topical application of fluoride varnish |
106 |
106 |
$1K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
157 |
156 |
$1K |
| 90672 |
|
262 |
258 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
67 |
66 |
$1K |
| 87653 |
|
28 |
28 |
$984.40 |
| 11100 |
|
26 |
24 |
$939.43 |
| 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 |
12 |
12 |
$813.60 |
| 86780 |
|
64 |
64 |
$773.00 |
| 81025 |
|
97 |
92 |
$693.57 |
| 81003 |
|
349 |
337 |
$687.91 |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$639.91 |
| 90756 |
|
41 |
41 |
$626.97 |
| 87340 |
|
63 |
63 |
$593.91 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$589.72 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
632 |
576 |
$552.97 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$550.08 |
| 99499 |
|
26 |
26 |
$468.00 |
| 80050 |
General health panel |
16 |
15 |
$464.21 |
| 36416 |
|
151 |
141 |
$420.89 |
| 90707 |
|
77 |
77 |
$402.85 |
| 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 |
18 |
18 |
$364.00 |
| 86762 |
|
24 |
24 |
$344.44 |
| 86703 |
|
24 |
24 |
$331.91 |
| D9999 |
Unspecified adjunctive procedure, by report |
14 |
14 |
$330.96 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
13 |
13 |
$329.31 |
| 85027 |
|
49 |
49 |
$325.48 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$265.14 |
| 20550 |
|
13 |
13 |
$260.94 |
| 90656 |
|
120 |
119 |
$219.14 |
| 90716 |
|
24 |
24 |
$203.65 |
| 84439 |
|
25 |
25 |
$194.42 |
| 87081 |
|
28 |
28 |
$182.27 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$178.82 |
| 83655 |
|
13 |
13 |
$165.50 |
| 99497 |
|
29 |
26 |
$138.23 |
| 81001 |
|
45 |
42 |
$124.25 |
| 90734 |
|
12 |
12 |
$112.05 |
| 92567 |
|
12 |
12 |
$111.51 |
| 90710 |
|
13 |
13 |
$99.60 |
| 90696 |
|
13 |
13 |
$99.60 |
| 90660 |
|
64 |
64 |
$87.48 |
| 86850 |
|
12 |
12 |
$78.02 |
| 86140 |
|
16 |
15 |
$59.50 |
| 90674 |
|
13 |
13 |
$57.25 |
| 51798 |
|
14 |
14 |
$37.94 |
| 1160F |
|
6,627 |
6,165 |
$35.48 |
| 1159F |
|
6,626 |
6,164 |
$35.47 |
| 86900 |
|
12 |
12 |
$31.59 |
| 86901 |
|
12 |
12 |
$28.62 |
| 3078F |
|
35,781 |
33,844 |
$25.78 |
| 85652 |
|
15 |
14 |
$24.68 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
33 |
31 |
$18.14 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
13 |
$6.76 |
| 3008F |
|
53,538 |
50,273 |
$3.33 |
| 3079F |
|
9,504 |
9,056 |
$2.81 |
| 3074F |
|
44,778 |
42,120 |
$1.66 |
| 1036F |
|
7,834 |
6,966 |
$1.43 |
| 0502F |
|
7,195 |
4,540 |
$0.02 |
| 3077F |
|
562 |
536 |
$0.00 |
| 3725F |
|
574 |
561 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
40 |
38 |
$0.00 |
| 3080F |
|
698 |
651 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
888 |
788 |
$0.00 |
| 1034F |
|
1,152 |
1,008 |
$0.00 |
| 1035F |
|
532 |
457 |
$0.00 |
| 3075F |
|
2,052 |
1,980 |
$0.00 |
| 3044F |
|
150 |
149 |
$0.00 |
| 99429 |
|
26 |
26 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
43 |
43 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
13 |
12 |
$0.00 |
| 99024 |
|
76 |
66 |
$0.00 |
| G2011 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes |
12 |
12 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
18 |
17 |
$0.00 |
| 99000 |
|
14 |
13 |
$0.00 |