| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,846 |
26,684 |
$3.20M |
| 99442 |
|
7,486 |
6,967 |
$644K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
4,516 |
4,326 |
$580K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,682 |
3,624 |
$478K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,502 |
1,472 |
$180K |
| 90674 |
|
4,342 |
4,340 |
$129K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,332 |
6,179 |
$113K |
| 99441 |
|
1,837 |
1,802 |
$95K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,232 |
1,199 |
$72K |
| H0001 |
Alcohol and/or drug assessment |
6,462 |
6,392 |
$41K |
| 93000 |
|
1,436 |
1,432 |
$23K |
| 99051 |
|
2,770 |
2,482 |
$17K |
| 90661 |
|
464 |
464 |
$15K |
| 0013A |
|
193 |
193 |
$8K |
| 90756 |
|
297 |
297 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
53 |
53 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
7,896 |
7,794 |
$6K |
| 83013 |
|
76 |
76 |
$5K |
| 3078F |
|
1,649 |
1,539 |
$4K |
| 83014 |
|
505 |
504 |
$4K |
| 3074F |
|
1,637 |
1,538 |
$3K |
| 0011A |
|
51 |
51 |
$2K |
| 0012A |
|
41 |
41 |
$2K |
| 94010 |
|
39 |
39 |
$1K |
| 3075F |
|
555 |
534 |
$1K |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
61 |
61 |
$1K |
| 3079F |
|
405 |
381 |
$1K |
| 3044F |
|
2,029 |
1,641 |
$860.00 |
| 3077F |
|
279 |
262 |
$860.00 |
| 90746 |
|
12 |
12 |
$811.86 |
| 99406 |
|
56 |
55 |
$571.73 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
135 |
133 |
$517.90 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,410 |
5,374 |
$438.58 |
| 3051F |
|
428 |
365 |
$320.00 |
| 90686 |
|
13 |
13 |
$229.45 |
| 1159F |
|
3,623 |
2,767 |
$205.00 |
| 1160F |
|
3,622 |
2,767 |
$102.50 |
| 3045F |
|
175 |
149 |
$40.00 |
| 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) |
2,159 |
1,926 |
$39.67 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
5,717 |
5,662 |
$2.98 |
| 1000F |
|
5,050 |
4,987 |
$2.78 |
| 1036F |
|
3,903 |
3,858 |
$1.78 |
| 3725F |
|
4,642 |
4,589 |
$1.78 |
| 3016F |
|
4,981 |
4,925 |
$1.78 |
| 90750 |
|
129 |
129 |
$1.13 |
| 91313 |
|
123 |
123 |
$0.52 |
| 91301 |
|
99 |
94 |
$0.14 |
| 91306 |
|
41 |
41 |
$0.06 |
| 3048F |
|
358 |
336 |
$0.01 |
| 3060F |
|
377 |
329 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
6,585 |
6,271 |
$0.00 |
| 3008F |
|
7,953 |
7,606 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
2,956 |
2,848 |
$0.00 |
| 3061F |
|
2,385 |
1,906 |
$0.00 |
| 1034F |
|
19 |
19 |
$0.00 |
| G9665 |
Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy |
1,634 |
1,497 |
$0.00 |
| G8506 |
Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
851 |
676 |
$0.00 |
| G9621 |
Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling |
123 |
121 |
$0.00 |
| 3050F |
|
923 |
870 |
$0.00 |
| 3015F |
|
112 |
100 |
$0.00 |
| 1032F |
|
198 |
194 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
28 |
24 |
$0.00 |