| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109,127 |
100,226 |
$3.46M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
138,043 |
124,470 |
$3.14M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15,774 |
10,632 |
$379K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,258 |
7,060 |
$273K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,702 |
7,008 |
$253K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,938 |
4,692 |
$207K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,210 |
4,119 |
$156K |
| 99233 |
Prolong inpt eval add15 m |
5,067 |
1,956 |
$145K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,329 |
4,166 |
$122K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,284 |
1,216 |
$117K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
13,870 |
11,935 |
$107K |
| 99223 |
Prolong inpt eval add15 m |
1,881 |
1,630 |
$95K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
499 |
461 |
$91K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,135 |
2,089 |
$91K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,806 |
2,683 |
$87K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
284 |
222 |
$81K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
657 |
618 |
$69K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
4,956 |
2,248 |
$65K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
5,870 |
2,904 |
$62K |
| 99215 |
Prolong outpt/office vis |
1,337 |
1,262 |
$53K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,763 |
1,599 |
$50K |
| 11721 |
|
6,821 |
6,421 |
$45K |
| 98926 |
|
3,853 |
3,200 |
$44K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
278 |
265 |
$40K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
655 |
627 |
$39K |
| 99406 |
|
6,760 |
5,713 |
$34K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
6,353 |
5,933 |
$33K |
| 99442 |
|
1,766 |
1,670 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,862 |
2,702 |
$29K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
626 |
562 |
$26K |
| 20610 |
|
1,065 |
892 |
$26K |
| 90686 |
|
2,921 |
2,832 |
$26K |
| 90633 |
|
1,722 |
1,686 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,215 |
1,149 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,973 |
1,831 |
$21K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
1,936 |
1,118 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
700 |
629 |
$19K |
| 99222 |
Initial hospital care, per day, moderate complexity |
555 |
523 |
$17K |
| 90670 |
|
3,877 |
3,801 |
$17K |
| 95811 |
|
292 |
275 |
$16K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
383 |
332 |
$16K |
| 93016 |
|
1,104 |
1,074 |
$15K |
| 94060 |
|
1,563 |
1,476 |
$15K |
| 99205 |
Prolong outpt/office vis |
234 |
223 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
379 |
356 |
$14K |
| 95886 |
|
829 |
692 |
$14K |
| 99307 |
|
3,534 |
3,121 |
$13K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
578 |
550 |
$12K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
80 |
78 |
$12K |
| 99441 |
|
1,117 |
1,072 |
$12K |
| 0011A |
|
402 |
325 |
$12K |
| 0012A |
|
430 |
299 |
$12K |
| 90698 |
|
3,938 |
3,869 |
$11K |
| 0071A |
|
108 |
100 |
$10K |
| 93971 |
|
715 |
690 |
$10K |
| 92134 |
|
1,808 |
1,671 |
$10K |
| 92015 |
Determination of refractive state |
547 |
497 |
$9K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
424 |
419 |
$9K |
| 93970 |
|
495 |
477 |
$9K |
| 93018 |
|
1,006 |
982 |
$8K |
| 99443 |
|
312 |
261 |
$8K |
| 99242 |
|
325 |
324 |
$7K |
| 99305 |
|
523 |
472 |
$6K |
| 0072A |
|
59 |
59 |
$6K |
| 99221 |
|
220 |
213 |
$5K |
| 92136 |
|
786 |
684 |
$5K |
| 90715 |
|
181 |
174 |
$5K |
| 90710 |
|
734 |
724 |
$5K |
| 95816 |
|
307 |
293 |
$5K |
| 92557 |
|
157 |
148 |
$4K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
40 |
19 |
$4K |
| 90677 |
|
14 |
14 |
$4K |
| 99243 |
|
106 |
106 |
$4K |
| 90651 |
|
503 |
496 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
199 |
196 |
$3K |
| 99460 |
|
37 |
36 |
$3K |
| 64615 |
|
40 |
40 |
$3K |
| 92083 |
|
303 |
288 |
$3K |
| 0081A |
|
30 |
29 |
$2K |
| 69210 |
|
388 |
327 |
$2K |
| 94726 |
|
645 |
619 |
$2K |
| 94729 |
|
657 |
631 |
$2K |
| 90744 |
|
1,424 |
1,390 |
$2K |
| 99381 |
|
41 |
41 |
$2K |
| 90672 |
|
712 |
708 |
$2K |
| 92567 |
|
242 |
230 |
$2K |
| 95251 |
|
282 |
252 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
72 |
26 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
150 |
142 |
$2K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
43 |
25 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
46 |
44 |
$2K |
| 90681 |
|
976 |
960 |
$2K |
| 0124A |
|
61 |
50 |
$2K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
44 |
44 |
$2K |
| 0013A |
|
17 |
17 |
$1K |
| 31231 |
|
71 |
69 |
$1K |
| 99219 |
|
57 |
54 |
$1K |
| 92250 |
|
125 |
113 |
$1K |
| 95912 |
|
14 |
13 |
$1K |
| 0031A |
|
38 |
37 |
$1K |
| 90685 |
|
402 |
387 |
$1K |
| 99245 |
|
12 |
12 |
$881.00 |
| 98925 |
|
103 |
91 |
$867.54 |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
15 |
12 |
$832.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
296 |
279 |
$699.69 |
| 90716 |
|
180 |
178 |
$695.28 |
| 93923 |
|
50 |
49 |
$642.03 |
| G3002 |
Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.) |
70 |
61 |
$566.92 |
| 90707 |
|
140 |
138 |
$524.96 |
| 99220 |
|
13 |
13 |
$504.91 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
27 |
27 |
$504.86 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
12 |
$484.29 |
| 90734 |
|
180 |
179 |
$473.30 |
| 99462 |
|
14 |
12 |
$468.05 |
| 62323 |
|
13 |
13 |
$439.22 |
| 93000 |
|
50 |
48 |
$407.97 |
| 90696 |
|
196 |
192 |
$295.40 |
| 92133 |
|
36 |
36 |
$263.56 |
| 93228 |
|
15 |
15 |
$258.83 |
| 90656 |
|
17 |
16 |
$217.62 |
| 64493 |
|
17 |
12 |
$194.64 |
| 99201 |
|
14 |
13 |
$186.74 |
| 91301 |
|
859 |
631 |
$165.78 |
| 99241 |
|
13 |
12 |
$154.56 |
| 64494 |
|
17 |
12 |
$112.37 |
| 94375 |
|
14 |
14 |
$112.18 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
607 |
431 |
$108.72 |
| 91300 |
|
27 |
25 |
$100.25 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$63.55 |
| 99310 |
Prolong nursin fac eval 15m |
16 |
15 |
$51.54 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,374 |
1,691 |
$46.15 |
| 90648 |
|
13 |
12 |
$20.00 |
| 90700 |
|
13 |
12 |
$20.00 |
| 91307 |
|
279 |
253 |
$2.13 |
| 91308 |
|
99 |
78 |
$0.70 |
| 91312 |
|
29 |
25 |
$0.29 |
| 3074F |
|
1,049 |
989 |
$0.00 |
| 3079F |
|
176 |
166 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |
| 3075F |
|
12 |
12 |
$0.00 |
| 3078F |
|
999 |
946 |
$0.00 |
| 3077F |
|
19 |
16 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
13 |
12 |
$0.00 |