| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
112,349 |
99,950 |
$3.51M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109,079 |
94,374 |
$3.02M |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
6,767 |
6,352 |
$335K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,388 |
4,859 |
$248K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
23,704 |
7,864 |
$248K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,858 |
3,276 |
$178K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,963 |
3,739 |
$174K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,881 |
7,670 |
$169K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,941 |
5,337 |
$152K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
7,017 |
6,128 |
$123K |
| 90674 |
|
5,728 |
5,346 |
$95K |
| 76830 |
Ultrasound, transvaginal |
1,279 |
1,220 |
$89K |
| 99215 |
Prolong outpt/office vis |
2,613 |
2,270 |
$87K |
| 93000 |
|
9,870 |
9,157 |
$87K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
10,069 |
8,951 |
$77K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
6,328 |
3,352 |
$73K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
8,105 |
3,641 |
$72K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,764 |
6,224 |
$72K |
| 99349 |
|
3,820 |
3,168 |
$68K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,336 |
1,076 |
$61K |
| 59426 |
|
1,094 |
759 |
$50K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
10,808 |
9,340 |
$49K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
8,488 |
6,547 |
$48K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,073 |
1,002 |
$47K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,327 |
1,820 |
$38K |
| 99442 |
|
2,947 |
2,582 |
$36K |
| 99460 |
|
462 |
444 |
$36K |
| 99222 |
Initial hospital care, per day, moderate complexity |
1,581 |
1,414 |
$36K |
| 99443 |
|
1,918 |
1,564 |
$35K |
| 59425 |
|
761 |
666 |
$35K |
| 93016 |
|
4,705 |
4,437 |
$34K |
| 90461 |
|
2,218 |
1,794 |
$32K |
| 99490 |
Ccm add 20min |
3,888 |
3,632 |
$31K |
| 99223 |
Prolong inpt eval add15 m |
891 |
773 |
$31K |
| 99350 |
Prolong home eval add 15m |
1,871 |
1,541 |
$29K |
| 99233 |
Prolong inpt eval add15 m |
1,877 |
773 |
$28K |
| 36415 |
Collection of venous blood by venipuncture |
15,974 |
14,834 |
$27K |
| 90686 |
|
2,468 |
2,405 |
$24K |
| 99386 |
|
515 |
469 |
$24K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
645 |
626 |
$22K |
| 99385 |
|
566 |
536 |
$22K |
| 93970 |
|
1,731 |
1,610 |
$20K |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
4,507 |
3,913 |
$20K |
| 99348 |
|
956 |
790 |
$17K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
150 |
137 |
$16K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
646 |
601 |
$14K |
| 47562 |
|
82 |
79 |
$14K |
| 81002 |
|
17,141 |
11,751 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
259 |
210 |
$13K |
| 99439 |
|
1,601 |
1,508 |
$13K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
669 |
633 |
$12K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
720 |
618 |
$10K |
| 99462 |
|
250 |
172 |
$10K |
| 99441 |
|
1,054 |
943 |
$9K |
| 90694 |
|
1,004 |
907 |
$7K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
703 |
623 |
$7K |
| 99497 |
|
1,529 |
1,297 |
$6K |
| 90671 |
|
593 |
413 |
$6K |
| 81025 |
|
2,035 |
1,850 |
$6K |
| 90670 |
|
199 |
181 |
$6K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
165 |
141 |
$5K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
3,150 |
2,780 |
$5K |
| 99205 |
Prolong outpt/office vis |
88 |
85 |
$5K |
| 96127 |
|
2,282 |
1,998 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
498 |
366 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,051 |
777 |
$4K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
341 |
152 |
$4K |
| 81001 |
|
1,864 |
1,810 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
49 |
$3K |
| 99306 |
Prolong nursin fac eval 15m |
149 |
126 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
151 |
123 |
$3K |
| 93971 |
|
404 |
380 |
$3K |
| 99220 |
|
100 |
97 |
$3K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
2,174 |
1,835 |
$3K |
| 99243 |
|
31 |
31 |
$3K |
| 99242 |
|
40 |
40 |
$2K |
| 51702 |
|
76 |
69 |
$2K |
| 76825 |
|
62 |
56 |
$2K |
| 99401 |
|
118 |
112 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
2,590 |
2,478 |
$2K |
| 99318 |
|
71 |
68 |
$2K |
| 90653 |
|
276 |
271 |
$2K |
| 90697 |
|
296 |
211 |
$2K |
| 90661 |
|
495 |
459 |
$2K |
| 99407 |
|
137 |
126 |
$2K |
| 76827 |
|
60 |
54 |
$1K |
| 90688 |
|
195 |
180 |
$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) |
616 |
533 |
$1K |
| 99495 |
|
43 |
42 |
$1K |
| 76821 |
|
62 |
56 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
362 |
186 |
$1K |
| 99000 |
|
12,605 |
10,372 |
$1K |
| 90756 |
|
108 |
108 |
$1K |
| 99221 |
|
95 |
84 |
$1K |
| 76820 |
|
62 |
56 |
$1K |
| 93325 |
|
137 |
129 |
$1K |
| 51701 |
|
40 |
33 |
$962.22 |
| 99253 |
|
14 |
13 |
$956.97 |
| 93922 |
|
38 |
38 |
$938.12 |
| 99201 |
|
37 |
36 |
$755.00 |
| 82962 |
|
1,667 |
1,217 |
$694.66 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
49 |
28 |
$677.48 |
| 99225 |
|
122 |
81 |
$668.16 |
| 90680 |
|
286 |
207 |
$666.52 |
| 99217 |
|
75 |
67 |
$613.76 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
57 |
55 |
$537.32 |
| 99347 |
|
13 |
12 |
$520.23 |
| 94010 |
|
43 |
42 |
$507.25 |
| 93040 |
|
173 |
103 |
$501.50 |
| G0181 |
Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans |
56 |
52 |
$400.39 |
| 99305 |
|
49 |
44 |
$357.43 |
| 93018 |
|
13 |
13 |
$352.59 |
| 94664 |
|
81 |
75 |
$338.68 |
| 90662 |
|
21 |
19 |
$288.83 |
| 90723 |
|
117 |
91 |
$279.31 |
| 95250 |
|
13 |
13 |
$271.23 |
| 99491 |
Ccm add 20min |
66 |
58 |
$267.27 |
| 99345 |
Prolong home eval add 15m |
13 |
12 |
$262.66 |
| 51798 |
|
57 |
38 |
$204.24 |
| G0180 |
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
24 |
24 |
$200.02 |
| 99218 |
|
16 |
13 |
$190.90 |
| 90648 |
|
249 |
186 |
$186.51 |
| 99152 |
|
14 |
13 |
$178.20 |
| 98967 |
|
29 |
26 |
$162.67 |
| 90700 |
|
99 |
70 |
$151.82 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
73 |
72 |
$144.85 |
| 99304 |
|
14 |
13 |
$143.50 |
| 99342 |
|
18 |
18 |
$120.74 |
| 36416 |
|
23 |
16 |
$111.80 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
15 |
14 |
$94.45 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12 |
12 |
$93.91 |
| 3008F |
|
6,835 |
5,111 |
$79.00 |
| 95251 |
|
13 |
13 |
$69.28 |
| 99334 |
|
36 |
22 |
$52.57 |
| 1111F |
|
3,234 |
2,949 |
$46.00 |
| 1159F |
|
4,231 |
3,288 |
$41.00 |
| 87210 |
|
12 |
12 |
$28.80 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
34,164 |
29,264 |
$23.10 |
| 81003 |
|
99 |
82 |
$15.37 |
| 1160F |
|
6,203 |
4,902 |
$12.00 |
| G0009 |
Administration of pneumococcal vaccine |
30 |
30 |
$11.50 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
102 |
87 |
$2.00 |
| 1170F |
|
1,935 |
1,574 |
$2.00 |
| 1125F |
|
244 |
202 |
$2.00 |
| 3078F |
|
2,640 |
2,169 |
$1.01 |
| 3074F |
|
2,856 |
2,337 |
$1.01 |
| 3288F |
|
4,900 |
4,329 |
$0.00 |
| 1033F |
|
4,264 |
3,698 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
2,188 |
1,898 |
$0.00 |
| 3725F |
|
90 |
80 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
233 |
227 |
$0.00 |
| 1100F |
|
66 |
63 |
$0.00 |
| 3077F |
|
29 |
27 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
121 |
100 |
$0.00 |
| 3028F |
|
56 |
51 |
$0.00 |
| G9899 |
Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed |
39 |
39 |
$0.00 |
| G9510 |
Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5 |
39 |
39 |
$0.00 |
| 3015F |
|
12 |
12 |
$0.00 |
| 97803 |
|
19 |
19 |
$0.00 |
| 99051 |
|
12 |
12 |
$0.00 |
| 1101F |
|
2,007 |
1,694 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
8,450 |
7,306 |
$0.00 |
| 1036F |
|
5,948 |
5,253 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
7,947 |
6,707 |
$0.00 |
| 0509F |
|
1,436 |
1,215 |
$0.00 |
| 1126F |
|
1,155 |
939 |
$0.00 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
2,860 |
2,382 |
$0.00 |
| 3079F |
|
915 |
785 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
454 |
393 |
$0.00 |
| 3075F |
|
396 |
346 |
$0.00 |
| 3017F |
|
198 |
176 |
$0.00 |
| 3044F |
|
264 |
210 |
$0.00 |
| 3014F |
|
16 |
12 |
$0.00 |
| 1123F |
|
28 |
25 |
$0.00 |
| 3048F |
|
31 |
17 |
$0.00 |