| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62,844 |
52,344 |
$3.25M |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
7,197 |
7,173 |
$425K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,719 |
5,690 |
$298K |
| 99442 |
|
4,304 |
4,124 |
$218K |
| 99443 |
|
3,172 |
3,102 |
$216K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
4,439 |
4,424 |
$146K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,858 |
2,838 |
$134K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,293 |
5,946 |
$120K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,222 |
3,014 |
$111K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,769 |
1,763 |
$80K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
7,143 |
6,777 |
$64K |
| 99490 |
Ccm add 20min |
7,156 |
7,126 |
$55K |
| 99397 |
|
649 |
648 |
$42K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
300 |
299 |
$23K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12,081 |
12,041 |
$18K |
| H0049 |
Alcohol and/or drug screening |
10,182 |
10,179 |
$17K |
| 3074F |
|
19,626 |
17,221 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,211 |
1,204 |
$15K |
| 3079F |
|
17,518 |
15,316 |
$14K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,795 |
9,779 |
$11K |
| 3078F |
|
11,334 |
10,278 |
$8K |
| 3075F |
|
8,665 |
7,777 |
$7K |
| 99406 |
|
776 |
758 |
$7K |
| 0013A |
|
177 |
177 |
$7K |
| 99173 |
|
13,260 |
13,249 |
$7K |
| 82270 |
|
2,835 |
2,795 |
$6K |
| 90686 |
|
2,665 |
2,657 |
$6K |
| 3077F |
|
4,904 |
4,341 |
$6K |
| 3080F |
|
4,332 |
3,930 |
$6K |
| 1125F |
|
23,377 |
20,379 |
$5K |
| 0011A |
|
158 |
158 |
$5K |
| 99441 |
|
201 |
197 |
$5K |
| 90688 |
|
835 |
834 |
$5K |
| 90756 |
|
332 |
331 |
$5K |
| 90734 |
|
525 |
525 |
$4K |
| 0012A |
|
115 |
115 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
25,810 |
25,514 |
$4K |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
14,113 |
14,092 |
$3K |
| 90633 |
|
539 |
538 |
$3K |
| 82043 |
|
4,898 |
4,892 |
$2K |
| 99496 |
|
27 |
27 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$2K |
| 90672 |
|
82 |
82 |
$2K |
| 97802 |
|
2,651 |
2,609 |
$1K |
| 0521F |
|
37,131 |
31,554 |
$1K |
| 90716 |
|
241 |
240 |
$1K |
| 90658 |
|
97 |
97 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
86 |
85 |
$1K |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
32,471 |
26,095 |
$1K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
47 |
47 |
$984.88 |
| H0001 |
Alcohol and/or drug assessment |
198 |
196 |
$910.00 |
| 83655 |
|
374 |
368 |
$852.98 |
| 1126F |
|
15,165 |
13,856 |
$806.72 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
72 |
67 |
$795.87 |
| 1159F |
|
38,132 |
30,671 |
$746.31 |
| 1160F |
|
37,699 |
30,045 |
$709.20 |
| 99401 |
|
49 |
47 |
$558.00 |
| 90651 |
|
1,145 |
1,142 |
$479.02 |
| 97803 |
|
159 |
157 |
$460.00 |
| 3046F |
|
462 |
456 |
$440.12 |
| 3044F |
|
4,648 |
4,611 |
$322.24 |
| 99072 |
|
646 |
596 |
$312.50 |
| 3051F |
|
449 |
445 |
$310.98 |
| 90707 |
|
121 |
120 |
$280.00 |
| 90715 |
|
207 |
205 |
$247.33 |
| G0124 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician |
66 |
66 |
$152.45 |
| 3052F |
|
180 |
178 |
$145.20 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
12,452 |
10,155 |
$126.72 |
| G0245 |
Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education |
438 |
349 |
$124.04 |
| S9451 |
Exercise classes, non-physician provider, per session |
1,745 |
1,689 |
$97.06 |
| 86592 |
|
82 |
82 |
$81.13 |
| 3066F |
|
1,666 |
1,617 |
$80.24 |
| 90461 |
|
37 |
37 |
$75.00 |
| 3061F |
|
2,378 |
2,364 |
$49.18 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
14,756 |
13,588 |
$45.00 |
| 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) |
3,180 |
2,989 |
$44.96 |
| 3045F |
|
544 |
538 |
$40.26 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
7,763 |
7,757 |
$30.00 |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
1,839 |
1,831 |
$29.64 |
| 90687 |
|
243 |
243 |
$9.41 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
6,190 |
6,163 |
$5.00 |
| 3008F |
|
28,956 |
25,911 |
$4.68 |
| 3048F |
|
3,373 |
3,346 |
$1.35 |
| 3049F |
|
1,745 |
1,735 |
$0.82 |
| 3050F |
|
1,180 |
1,173 |
$0.74 |
| G2089 |
Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0% |
183 |
183 |
$0.45 |
| 4010F |
|
2,182 |
2,089 |
$0.38 |
| 91301 |
|
203 |
201 |
$0.26 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
493 |
472 |
$0.20 |
| 2022F |
|
505 |
498 |
$0.12 |
| 1000F |
|
23,112 |
21,037 |
$0.00 |
| 1006F |
|
147 |
145 |
$0.00 |
| 4293F |
|
2,237 |
2,150 |
$0.00 |
| 1034F |
|
1,664 |
1,518 |
$0.00 |
| 1036F |
|
21,333 |
19,445 |
$0.00 |
| 3060F |
|
320 |
318 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
1,467 |
1,417 |
$0.00 |
| 4000F |
|
586 |
578 |
$0.00 |
| 3017F |
|
564 |
562 |
$0.00 |
| G9189 |
Beta-blocker therapy prescribed or currently being taken |
950 |
899 |
$0.00 |
| 4086F |
|
1,044 |
977 |
$0.00 |
| 90619 |
|
158 |
157 |
$0.00 |
| 36410 |
|
81 |
79 |
$0.00 |
| 99429 |
|
1,347 |
1,102 |
$0.00 |
| 2023F |
|
110 |
109 |
$0.00 |
| G8430 |
Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status) |
36 |
36 |
$0.00 |
| 3014F |
|
182 |
182 |
$0.00 |
| G9906 |
Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
279 |
254 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
117 |
113 |
$0.00 |
| S0612 |
Annual gynecological examination, established patient |
18 |
18 |
$0.00 |
| 4004F |
|
894 |
824 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
400 |
400 |
$0.00 |
| 3725F |
|
12,564 |
12,477 |
$0.00 |
| 3016F |
|
12,131 |
12,115 |
$0.00 |
| 3062F |
|
164 |
161 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
5,235 |
4,843 |
$0.00 |
| 4013F |
|
1,243 |
1,235 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
116 |
109 |
$0.00 |
| 2028F |
|
1,304 |
1,300 |
$0.00 |
| G9276 |
Documentation that patient is a current tobacco user |
210 |
200 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
19 |
19 |
$0.00 |
| 3015F |
|
338 |
337 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
114 |
110 |
$0.00 |
| 90713 |
|
34 |
34 |
$0.00 |
| G9899 |
Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed |
69 |
69 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
64 |
63 |
$0.00 |
| G8509 |
Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given |
45 |
44 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
52 |
47 |
$0.00 |