| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
62,492 |
56,960 |
$3.31M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
30,161 |
28,485 |
$1.37M |
| 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 |
7,857 |
7,311 |
$1.03M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,411 |
4,135 |
$409K |
| G0659 |
Drug test(s), definitive, utilizing 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), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes |
6,194 |
6,166 |
$335K |
| 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 |
3,172 |
3,063 |
$283K |
| 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 |
2,260 |
2,158 |
$281K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
8,939 |
8,669 |
$211K |
| 64483 |
|
1,313 |
1,103 |
$198K |
| 77002 |
|
3,707 |
3,044 |
$132K |
| 80050 |
General health panel |
2,947 |
2,771 |
$126K |
| 82607 |
|
8,966 |
8,697 |
$108K |
| 82746 |
|
8,522 |
8,266 |
$100K |
| 82728 |
|
6,779 |
6,604 |
$78K |
| 64493 |
|
526 |
424 |
$75K |
| 80053 |
Comprehensive metabolic panel |
8,138 |
7,879 |
$67K |
| 83735 |
|
12,398 |
11,907 |
$67K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,325 |
1,253 |
$66K |
| 99441 |
|
1,606 |
1,522 |
$66K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
414 |
414 |
$64K |
| 20610 |
|
2,273 |
1,829 |
$64K |
| 83550 |
|
6,537 |
6,370 |
$48K |
| 82550 |
|
8,535 |
8,166 |
$45K |
| 84100 |
|
11,874 |
11,387 |
$43K |
| 84550 |
|
11,650 |
11,111 |
$42K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,344 |
6,159 |
$38K |
| 83540 |
|
6,719 |
6,552 |
$37K |
| 83992 |
|
2,860 |
2,814 |
$36K |
| 80305 |
|
3,458 |
3,401 |
$34K |
| 80356 |
|
2,852 |
2,806 |
$34K |
| 64494 |
|
466 |
371 |
$34K |
| 99443 |
|
693 |
513 |
$31K |
| 80324 |
|
2,669 |
2,626 |
$30K |
| 80353 |
|
2,680 |
2,637 |
$25K |
| 80361 |
|
1,871 |
1,853 |
$24K |
| 20553 |
|
568 |
543 |
$23K |
| 80348 |
|
1,683 |
1,677 |
$22K |
| 36415 |
Collection of venous blood by venipuncture |
9,636 |
9,113 |
$22K |
| 80359 |
|
2,854 |
2,808 |
$22K |
| 80354 |
|
1,771 |
1,755 |
$21K |
| 80365 |
|
1,786 |
1,769 |
$19K |
| 99442 |
|
385 |
319 |
$19K |
| 80362 |
|
1,772 |
1,756 |
$19K |
| 80372 |
|
1,771 |
1,755 |
$17K |
| 80373 |
|
1,815 |
1,799 |
$17K |
| 80358 |
|
1,699 |
1,683 |
$17K |
| 80355 |
|
2,159 |
2,131 |
$16K |
| 80366 |
|
2,092 |
2,064 |
$14K |
| CP004 |
|
1,470 |
1,405 |
$13K |
| 64484 |
|
148 |
130 |
$13K |
| 80306 |
|
814 |
811 |
$12K |
| 64495 |
|
119 |
103 |
$10K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16,264 |
14,210 |
$10K |
| 62323 |
|
66 |
52 |
$9K |
| 81226 |
|
16 |
16 |
$6K |
| 80346 |
|
436 |
435 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
446 |
421 |
$5K |
| 64635 |
|
13 |
12 |
$4K |
| 27096 |
|
43 |
41 |
$4K |
| 81225 |
|
16 |
16 |
$4K |
| 80336 |
|
205 |
205 |
$3K |
| 81401 |
|
28 |
16 |
$3K |
| 80360 |
|
304 |
304 |
$3K |
| 80345 |
|
300 |
300 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
376 |
358 |
$2K |
| 81227 |
|
16 |
16 |
$2K |
| 64636 |
|
15 |
13 |
$2K |
| 86003 |
|
12 |
12 |
$2K |
| 85027 |
|
202 |
201 |
$1K |
| 82530 |
|
99 |
98 |
$1K |
| 81355 |
|
16 |
16 |
$1K |
| 81241 |
|
16 |
16 |
$1K |
| 81240 |
|
16 |
16 |
$926.25 |
| 81291 |
|
16 |
16 |
$921.30 |
| 81400 |
|
16 |
16 |
$781.56 |
| 80335 |
|
93 |
93 |
$378.00 |
| 84403 |
|
12 |
12 |
$353.06 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
445 |
420 |
$337.84 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$316.27 |
| 84681 |
|
12 |
12 |
$289.92 |
| 86225 |
|
17 |
16 |
$201.90 |
| 86200 |
|
17 |
16 |
$185.25 |
| 86431 |
|
16 |
15 |
$162.19 |
| 83525 |
|
12 |
12 |
$159.12 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
219 |
201 |
$130.89 |
| 86140 |
|
16 |
15 |
$74.09 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
348 |
292 |
$65.22 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
28 |
28 |
$64.01 |
| 85651 |
|
16 |
15 |
$53.24 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
571 |
547 |
$0.69 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
311 |
304 |
$0.38 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
227 |
221 |
$0.00 |
| 1036F |
|
482 |
461 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
48 |
47 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
213 |
207 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
170 |
165 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
111 |
105 |
$0.00 |
| 1124F |
|
339 |
292 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
568 |
545 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
579 |
552 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
321 |
304 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
600 |
573 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
415 |
372 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
43 |
42 |
$0.00 |
| 4004F |
|
67 |
63 |
$0.00 |