| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
154,744 |
123,596 |
$3.88M |
| 64493 |
|
13,239 |
8,460 |
$1.28M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
36,973 |
27,862 |
$938K |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
15,767 |
10,615 |
$809K |
| 64635 |
|
4,305 |
3,445 |
$731K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
7,467 |
6,166 |
$472K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,642 |
18,815 |
$361K |
| 20610 |
|
13,761 |
10,158 |
$352K |
| 27096 |
|
4,293 |
3,049 |
$339K |
| 64494 |
|
14,505 |
8,167 |
$336K |
| 20553 |
|
10,178 |
8,478 |
$244K |
| 77002 |
|
13,433 |
10,130 |
$243K |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
4,559 |
3,100 |
$235K |
| 64636 |
|
4,137 |
3,132 |
$163K |
| 64490 |
|
728 |
606 |
$103K |
| 80305 |
|
15,172 |
12,418 |
$91K |
| 99454 |
|
16,018 |
12,427 |
$55K |
| 64495 |
|
5,130 |
3,487 |
$50K |
| 62323 |
|
240 |
205 |
$27K |
| 64491 |
|
722 |
537 |
$20K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
46,126 |
35,036 |
$18K |
| 99457 |
|
15,163 |
11,626 |
$18K |
| 64633 |
|
85 |
71 |
$16K |
| 64492 |
|
289 |
248 |
$15K |
| 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 |
328 |
198 |
$15K |
| 99458 |
|
8,424 |
6,232 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,846 |
2,056 |
$10K |
| 64634 |
|
100 |
79 |
$6K |
| 99205 |
Prolong outpt/office vis |
99 |
87 |
$5K |
| 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 |
381 |
254 |
$4K |
| 96138 |
|
16,541 |
12,316 |
$3K |
| 80373 |
|
324 |
288 |
$2K |
| 80357 |
|
324 |
289 |
$2K |
| 80368 |
|
323 |
288 |
$2K |
| 80370 |
|
322 |
287 |
$2K |
| 80347 |
|
302 |
286 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
40 |
31 |
$2K |
| 20611 |
|
127 |
69 |
$2K |
| 80365 |
|
301 |
285 |
$2K |
| 80356 |
|
301 |
285 |
$2K |
| 80348 |
|
302 |
286 |
$2K |
| 80354 |
|
302 |
286 |
$2K |
| 80364 |
|
302 |
286 |
$2K |
| 80349 |
|
302 |
286 |
$2K |
| 80371 |
|
302 |
286 |
$2K |
| 80358 |
|
302 |
286 |
$2K |
| 80352 |
|
302 |
286 |
$2K |
| 80360 |
|
303 |
286 |
$2K |
| 80331 |
|
322 |
288 |
$2K |
| 80353 |
|
302 |
286 |
$2K |
| 80359 |
|
302 |
286 |
$2K |
| 80326 |
|
301 |
286 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,028 |
2,205 |
$1K |
| 80322 |
|
299 |
286 |
$1K |
| 80345 |
|
301 |
286 |
$1K |
| 99453 |
|
273 |
237 |
$750.12 |
| 20552 |
|
19 |
16 |
$431.36 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
12 |
$387.43 |
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
122 |
119 |
$271.80 |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
80 |
77 |
$271.80 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
13 |
$77.96 |
| 97750 |
|
147 |
107 |
$46.48 |
| 99051 |
|
90 |
90 |
$36.40 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
5,141 |
4,558 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
4,473 |
3,639 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
10,208 |
7,553 |
$0.00 |
| G9583 |
Patients prescribed opiates for longer than six weeks |
8,811 |
7,813 |
$0.00 |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
48 |
29 |
$0.00 |
| L0180 |
Cervical, multiple post collar, occipital/mandibular supports, adjustable |
12 |
12 |
$0.00 |
| G9561 |
Patients prescribed opiates for longer than six weeks |
8,807 |
7,814 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
10,724 |
9,426 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
5,266 |
4,579 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
5,751 |
4,137 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
10,708 |
9,414 |
$0.00 |
| G9584 |
Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy |
8,813 |
7,817 |
$0.00 |
| G9578 |
Documentation of signed opioid treatment agreement at least once during opioid therapy |
10,091 |
8,892 |
$0.00 |
| G9577 |
Patients prescribed opiates for longer than six weeks |
10,089 |
8,889 |
$0.00 |
| G9562 |
Patients who had a follow-up evaluation conducted at least every three months during opioid therapy |
8,809 |
7,813 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
8,817 |
6,990 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
4,850 |
4,349 |
$0.00 |
| 80355 |
|
306 |
287 |
$0.00 |