| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
65,206 |
20,438 |
$2.05M |
| T1015 |
Clinic visit/encounter, all-inclusive |
13,608 |
10,488 |
$635K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,982 |
5,942 |
$569K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,988 |
3,430 |
$545K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,939 |
4,490 |
$512K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,149 |
3,366 |
$262K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,178 |
1,853 |
$220K |
| G0445 |
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes |
2,319 |
2,242 |
$195K |
| 99441 |
|
1,661 |
1,565 |
$193K |
| 20552 |
|
1,068 |
931 |
$188K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
262 |
259 |
$140K |
| 90791 |
Psychiatric diagnostic evaluation |
770 |
728 |
$121K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,102 |
1,946 |
$120K |
| 99443 |
|
2,217 |
1,719 |
$119K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
1,409 |
1,240 |
$112K |
| 99401 |
|
3,365 |
2,965 |
$109K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,027 |
828 |
$93K |
| 93880 |
|
238 |
223 |
$91K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
509 |
440 |
$91K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
528 |
526 |
$87K |
| 93970 |
|
198 |
184 |
$85K |
| 99454 |
|
8,767 |
5,236 |
$81K |
| 99000 |
|
5,385 |
4,415 |
$75K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
696 |
643 |
$66K |
| 76942 |
|
389 |
376 |
$65K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
882 |
879 |
$65K |
| 96160 |
|
1,471 |
1,387 |
$56K |
| 99385 |
|
665 |
634 |
$53K |
| 11900 |
|
160 |
148 |
$44K |
| 11721 |
|
1,165 |
874 |
$41K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,489 |
1,476 |
$39K |
| 99442 |
|
729 |
634 |
$37K |
| 92201 |
|
589 |
584 |
$37K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
194 |
81 |
$33K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
919 |
914 |
$32K |
| 93925 |
|
94 |
87 |
$32K |
| 99457 |
|
5,678 |
5,373 |
$29K |
| 0002A |
|
983 |
966 |
$27K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
363 |
359 |
$26K |
| 0001A |
|
1,047 |
1,017 |
$26K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
47 |
46 |
$25K |
| 99386 |
|
227 |
219 |
$23K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,296 |
1,160 |
$23K |
| 99406 |
|
536 |
499 |
$22K |
| 20611 |
|
57 |
46 |
$22K |
| H0001 |
Alcohol and/or drug assessment |
198 |
198 |
$20K |
| 2000F |
|
14,413 |
6,665 |
$17K |
| 99091 |
|
296 |
296 |
$13K |
| 36415 |
Collection of venous blood by venipuncture |
4,666 |
4,320 |
$12K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
100 |
97 |
$12K |
| 93975 |
|
21 |
21 |
$11K |
| 86328 |
|
297 |
249 |
$10K |
| 90834 |
Psychotherapy, 45 minutes with patient |
61 |
42 |
$10K |
| 0003A |
|
292 |
260 |
$10K |
| 1159F |
|
8,690 |
6,562 |
$10K |
| 95250 |
|
60 |
49 |
$9K |
| 93015 |
|
58 |
58 |
$8K |
| 17110 |
|
34 |
29 |
$8K |
| 11056 |
|
25 |
25 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
102 |
69 |
$7K |
| 94060 |
|
27 |
27 |
$7K |
| 90674 |
|
247 |
247 |
$6K |
| 92133 |
|
69 |
68 |
$5K |
| 51798 |
|
14 |
14 |
$5K |
| 93000 |
|
693 |
544 |
$5K |
| 1126F |
|
5,496 |
3,833 |
$4K |
| 81002 |
|
1,220 |
1,023 |
$4K |
| 82962 |
|
553 |
278 |
$4K |
| 57410 |
|
67 |
57 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
26 |
26 |
$3K |
| 95251 |
|
41 |
35 |
$3K |
| 20610 |
|
14 |
12 |
$3K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
215 |
178 |
$2K |
| 99453 |
|
457 |
296 |
$2K |
| 92250 |
|
27 |
27 |
$2K |
| 80305 |
|
1,373 |
1,210 |
$2K |
| 10040 |
|
13 |
13 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
422 |
398 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
215 |
215 |
$2K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
14 |
14 |
$2K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,519 |
1,138 |
$2K |
| 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 |
83 |
81 |
$2K |
| 92015 |
Determination of refractive state |
474 |
466 |
$2K |
| 99490 |
Ccm add 20min |
291 |
274 |
$2K |
| S0610 |
Annual gynecological examination, new patient |
26 |
26 |
$1K |
| 20553 |
|
57 |
40 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
215 |
206 |
$1K |
| 99051 |
|
113 |
113 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
112 |
72 |
$1K |
| 99459 |
|
26 |
26 |
$1K |
| 36000 |
|
40 |
40 |
$1K |
| 11719 |
|
14 |
14 |
$887.51 |
| 92134 |
|
12 |
12 |
$655.01 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
228 |
206 |
$579.55 |
| 87070 |
|
157 |
153 |
$518.60 |
| 3074F |
|
3,951 |
3,398 |
$518.50 |
| 99458 |
|
354 |
341 |
$510.35 |
| 99050 |
|
80 |
80 |
$506.76 |
| 1125F |
|
2,422 |
2,099 |
$390.80 |
| 90661 |
|
12 |
12 |
$360.76 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
968 |
892 |
$360.49 |
| 3079F |
|
1,936 |
1,755 |
$355.16 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
942 |
754 |
$339.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30 |
30 |
$332.24 |
| 99348 |
|
75 |
13 |
$284.22 |
| 3078F |
|
3,222 |
2,797 |
$270.49 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,269 |
1,193 |
$263.85 |
| 2001F |
|
6,189 |
5,281 |
$183.02 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
3,670 |
3,044 |
$150.40 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
15 |
15 |
$150.00 |
| 99344 |
|
14 |
14 |
$130.25 |
| 96127 |
|
114 |
113 |
$113.68 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
447 |
405 |
$106.08 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
304 |
253 |
$103.36 |
| 81025 |
|
33 |
33 |
$97.01 |
| 3077F |
|
907 |
807 |
$92.50 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
4,523 |
3,637 |
$88.68 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
257 |
219 |
$88.40 |
| 3080F |
|
604 |
537 |
$80.00 |
| 3075F |
|
769 |
726 |
$77.50 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,510 |
1,316 |
$39.11 |
| 3028F |
|
6,804 |
5,629 |
$38.21 |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
38 |
38 |
$28.19 |
| 1160F |
|
5,795 |
4,990 |
$24.70 |
| 2010F |
|
6,553 |
5,576 |
$22.72 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
567 |
504 |
$10.27 |
| 3044F |
|
927 |
845 |
$5.99 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
1,369 |
1,231 |
$3.19 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
81 |
71 |
$0.86 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,814 |
1,598 |
$0.28 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
392 |
352 |
$0.07 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,278 |
1,221 |
$0.07 |
| G4028 |
Podiatry mips specialty set |
542 |
528 |
$0.06 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
528 |
467 |
$0.05 |
| G4018 |
Obstetrics/gynecology mips specialty set |
818 |
784 |
$0.03 |
| 3008F |
|
7,209 |
6,077 |
$0.01 |
| 1036F |
|
2,618 |
2,247 |
$0.01 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
73 |
70 |
$0.01 |
| 2018F |
|
1,835 |
1,622 |
$0.01 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
76 |
75 |
$0.01 |
| 3754F |
|
230 |
222 |
$0.00 |
| 1170F |
|
159 |
150 |
$0.00 |
| 3048F |
|
412 |
379 |
$0.00 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
12 |
12 |
$0.00 |
| 4011F |
|
214 |
181 |
$0.00 |
| 4010F |
|
89 |
82 |
$0.00 |
| 1034F |
|
557 |
473 |
$0.00 |
| 3279F |
|
263 |
242 |
$0.00 |
| 3514F |
|
68 |
67 |
$0.00 |
| 3049F |
|
192 |
174 |
$0.00 |
| M1207 |
Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
106 |
101 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
693 |
581 |
$0.00 |
| 3510F |
|
69 |
68 |
$0.00 |
| 1006F |
|
64 |
64 |
$0.00 |
| G2197 |
Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user |
113 |
110 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
30 |
29 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
54 |
53 |
$0.00 |
| 1000F |
|
193 |
171 |
$0.00 |
| 3011F |
|
244 |
232 |
$0.00 |
| 4008F |
|
47 |
41 |
$0.00 |
| 1220F |
|
17 |
17 |
$0.00 |
| 90656 |
|
14 |
14 |
$0.00 |
| 3512F |
|
65 |
61 |
$0.00 |
| 3120F |
|
25 |
25 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
525 |
511 |
$0.00 |
| 2029F |
|
551 |
492 |
$0.00 |
| 4004F |
|
367 |
361 |
$0.00 |
| 2028F |
|
547 |
531 |
$0.00 |
| 1137F |
|
565 |
537 |
$0.00 |
| 1090F |
|
75 |
70 |
$0.00 |
| 3725F |
|
376 |
370 |
$0.00 |
| 3511F |
|
377 |
355 |
$0.00 |
| 4013F |
|
692 |
585 |
$0.00 |
| 1033F |
|
634 |
589 |
$0.00 |
| 3280F |
|
180 |
168 |
$0.00 |
| 3513F |
|
68 |
67 |
$0.00 |
| 3015F |
|
190 |
174 |
$0.00 |
| 3016F |
|
143 |
129 |
$0.00 |
| 1100F |
|
64 |
56 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
16 |
16 |
$0.00 |
| 3050F |
|
140 |
120 |
$0.00 |
| 4025F |
|
23 |
17 |
$0.00 |
| G9796 |
Patient is currently on a high intensity statin therapy |
13 |
13 |
$0.00 |
| 3020F |
|
27 |
25 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
14 |
14 |
$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) |
27 |
27 |
$0.00 |