| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,848 |
6,836 |
$49K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,830 |
1,676 |
$27K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
2,343 |
2,274 |
$23K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
2,406 |
2,384 |
$23K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
2,230 |
2,025 |
$15K |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
727 |
649 |
$13K |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
6,217 |
5,427 |
$11K |
| 3078F |
|
5,526 |
4,805 |
$7K |
| 3074F |
|
5,115 |
4,488 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
947 |
944 |
$5K |
| 93000 |
|
417 |
412 |
$4K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
159 |
159 |
$4K |
| H0001 |
Alcohol and/or drug assessment |
5,825 |
5,223 |
$4K |
| 99497 |
|
72 |
68 |
$3K |
| 99403 |
|
1,670 |
1,537 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
295 |
294 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
255 |
254 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
193 |
188 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
4,772 |
4,241 |
$1K |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
5,924 |
5,298 |
$1K |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
240 |
238 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
106 |
105 |
$912.61 |
| 1126F |
|
2,719 |
2,449 |
$903.55 |
| 99606 |
|
52 |
52 |
$704.25 |
| 1159F |
|
4,710 |
4,136 |
$681.80 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
27 |
27 |
$677.88 |
| G9507 |
Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs) |
5,161 |
4,593 |
$628.75 |
| 1160F |
|
4,895 |
4,280 |
$599.30 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
5,434 |
4,835 |
$492.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
5,358 |
4,765 |
$375.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
4,971 |
4,453 |
$330.00 |
| 3079F |
|
179 |
168 |
$292.50 |
| 90658 |
|
68 |
67 |
$275.16 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
466 |
462 |
$270.00 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
1,160 |
1,048 |
$261.00 |
| 90732 |
|
13 |
13 |
$228.42 |
| 1125F |
|
757 |
733 |
$208.00 |
| 99401 |
|
44 |
42 |
$202.65 |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
307 |
257 |
$195.00 |
| 3075F |
|
143 |
137 |
$175.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$174.85 |
| 99429 |
|
57 |
50 |
$160.00 |
| 3044F |
|
839 |
825 |
$159.70 |
| 3077F |
|
100 |
93 |
$137.50 |
| 36415 |
Collection of venous blood by venipuncture |
3,232 |
3,180 |
$136.24 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
60 |
59 |
$134.19 |
| 99386 |
|
25 |
24 |
$119.52 |
| 3048F |
|
432 |
397 |
$113.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
524 |
448 |
$112.74 |
| 0521F |
|
952 |
909 |
$98.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
254 |
253 |
$95.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$95.00 |
| 99397 |
|
12 |
12 |
$90.88 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
213 |
179 |
$90.00 |
| 3049F |
|
190 |
173 |
$60.00 |
| 1170F |
|
69 |
61 |
$55.10 |
| 82947 |
|
17 |
15 |
$51.28 |
| 3050F |
|
232 |
211 |
$50.00 |
| G9150 |
National committee for quality assurance - level 3 medical home |
1,261 |
1,039 |
$30.00 |
| G0136 |
Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months |
31 |
31 |
$20.14 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
14 |
$18.41 |
| 3008F |
|
5,942 |
5,133 |
$15.46 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,360 |
2,099 |
$15.00 |
| 3011F |
|
1,553 |
1,454 |
$15.00 |
| 94760 |
|
130 |
119 |
$13.27 |
| 3014F |
|
416 |
397 |
$10.00 |
| 82948 |
|
935 |
935 |
$8.34 |
| G9797 |
Patient is not on a high intensity statin therapy |
174 |
158 |
$7.50 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
554 |
518 |
$6.33 |
| 1158F |
|
378 |
334 |
$5.10 |
| 1157F |
|
381 |
335 |
$5.10 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$5.00 |
| G9621 |
Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling |
57 |
51 |
$3.75 |
| 4010F |
|
1,489 |
1,317 |
$0.08 |
| M1200 |
Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period |
132 |
129 |
$0.02 |
| 2022F |
|
1,063 |
1,043 |
$0.01 |
| 0556F |
|
1,781 |
1,628 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
1,502 |
1,280 |
$0.00 |
| 4013F |
|
1,024 |
933 |
$0.00 |
| 3513F |
|
1,798 |
1,622 |
$0.00 |
| 3725F |
|
2,448 |
2,281 |
$0.00 |
| 3511F |
|
964 |
929 |
$0.00 |
| G8935 |
Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
1,713 |
1,533 |
$0.00 |
| 3016F |
|
3,517 |
3,090 |
$0.00 |
| G8506 |
Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
1,449 |
1,281 |
$0.00 |
| 99080 |
|
2,517 |
114 |
$0.00 |
| 4019F |
|
435 |
429 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
221 |
212 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
172 |
156 |
$0.00 |
| 3015F |
|
794 |
767 |
$0.00 |
| 4274F |
|
29 |
29 |
$0.00 |
| 90863 |
|
36 |
36 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
42 |
41 |
$0.00 |
| 99408 |
|
19 |
19 |
$0.00 |
| A4927 |
Gloves, non-sterile, per 100 |
15 |
14 |
$0.00 |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
28 |
20 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
17 |
17 |
$0.00 |
| 4025F |
|
13 |
13 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
395 |
337 |
$0.00 |
| 1036F |
|
1,989 |
1,714 |
$0.00 |
| 3512F |
|
1,856 |
1,675 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
3,109 |
2,764 |
$0.00 |
| 1000F |
|
1,799 |
1,552 |
$0.00 |
| 3514F |
|
1,796 |
1,624 |
$0.00 |
| G9228 |
Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) |
113 |
111 |
$0.00 |
| 2016F |
|
16 |
12 |
$0.00 |
| 2010F |
|
2,013 |
1,877 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
252 |
206 |
$0.00 |
| 3017F |
|
74 |
69 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
71 |
63 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
12 |
12 |
$0.00 |
| 4086F |
|
71 |
58 |
$0.00 |
| 1022F |
|
13 |
13 |
$0.00 |
| 1006F |
|
15 |
14 |
$0.00 |
| 2015F |
|
31 |
26 |
$0.00 |
| 4011F |
|
26 |
26 |
$0.00 |
| 1005F |
|
16 |
12 |
$0.00 |