| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,693 |
12,680 |
$138K |
| 99441 |
|
2,886 |
2,574 |
$49K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,800 |
2,770 |
$30K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,149 |
2,119 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,197 |
2,042 |
$12K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
4,122 |
4,098 |
$11K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,239 |
3,847 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,219 |
1,205 |
$7K |
| 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 |
3,525 |
3,497 |
$4K |
| 99442 |
|
907 |
826 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
377 |
377 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
6,035 |
5,876 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
445 |
442 |
$2K |
| S9470 |
Nutritional counseling, dietitian visit |
5,723 |
5,683 |
$2K |
| S9451 |
Exercise classes, non-physician provider, per session |
5,532 |
5,486 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,010 |
1,987 |
$2K |
| 3074F |
|
2,020 |
1,963 |
$2K |
| 87110 |
|
145 |
140 |
$2K |
| 3078F |
|
1,779 |
1,723 |
$1K |
| 90658 |
|
186 |
185 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
106 |
106 |
$1K |
| 99401 |
|
5,919 |
5,820 |
$911.36 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
43 |
43 |
$900.30 |
| 82270 |
|
789 |
777 |
$715.31 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
91 |
91 |
$655.14 |
| G0008 |
Administration of influenza virus vaccine |
979 |
976 |
$650.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,363 |
5,166 |
$507.00 |
| 82042 |
|
881 |
874 |
$426.90 |
| 90734 |
|
13 |
13 |
$425.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$373.85 |
| 3079F |
|
466 |
461 |
$350.17 |
| 88150 |
|
180 |
178 |
$324.30 |
| 86580 |
|
60 |
58 |
$284.11 |
| 90686 |
|
340 |
340 |
$281.67 |
| H0001 |
Alcohol and/or drug assessment |
2,796 |
2,754 |
$162.10 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21 |
21 |
$132.94 |
| 3077F |
|
112 |
109 |
$115.01 |
| 96127 |
|
3,660 |
3,629 |
$106.77 |
| 3080F |
|
68 |
63 |
$90.00 |
| 90756 |
|
38 |
38 |
$68.37 |
| 1111F |
|
41 |
40 |
$60.00 |
| 1159F |
|
1,932 |
1,869 |
$55.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
63 |
60 |
$46.21 |
| 99406 |
|
32 |
32 |
$32.38 |
| 3049F |
|
361 |
347 |
$10.10 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
2,995 |
2,986 |
$5.00 |
| 99000 |
|
6,876 |
6,261 |
$2.00 |
| 3048F |
|
677 |
658 |
$0.12 |
| 3050F |
|
309 |
298 |
$0.07 |
| 3044F |
|
174 |
167 |
$0.05 |
| 3008F |
|
1,224 |
1,211 |
$0.03 |
| 4010F |
|
473 |
460 |
$0.02 |
| G9275 |
Documentation that patient is a current non-tobacco user |
3,948 |
3,905 |
$0.00 |
| 1036F |
|
4,480 |
4,407 |
$0.00 |
| 1000F |
|
4,789 |
4,710 |
$0.00 |
| 97802 |
|
997 |
995 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
163 |
162 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
496 |
480 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
1,586 |
1,576 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
1,823 |
1,789 |
$0.00 |
| 99429 |
|
464 |
460 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
101 |
101 |
$0.00 |
| 4000F |
|
34 |
34 |
$0.00 |
| 98967 |
|
12 |
12 |
$0.00 |
| 90674 |
|
14 |
14 |
$0.00 |
| 90656 |
|
24 |
24 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,937 |
2,894 |
$0.00 |
| 3725F |
|
5,336 |
5,215 |
$0.00 |
| 4013F |
|
848 |
824 |
$0.00 |
| G9276 |
Documentation that patient is a current tobacco user |
93 |
93 |
$0.00 |
| 96160 |
|
463 |
460 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
110 |
106 |
$0.00 |
| 1160F |
|
819 |
775 |
$0.00 |
| 99408 |
|
856 |
853 |
$0.00 |
| 1032F |
|
93 |
93 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
179 |
174 |
$0.00 |
| 4004F |
|
571 |
560 |
$0.00 |
| 3016F |
|
3,121 |
3,079 |
$0.00 |
| 90687 |
|
30 |
30 |
$0.00 |
| 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) |
18 |
16 |
$0.00 |
| 3045F |
|
57 |
54 |
$0.00 |
| 3051F |
|
12 |
12 |
$0.00 |
| 98966 |
|
32 |
29 |
$0.00 |