| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,837 |
14,242 |
$154K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
3,314 |
3,295 |
$73K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,504 |
7,596 |
$64K |
| 93000 |
|
3,686 |
3,682 |
$45K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
2,863 |
2,677 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,645 |
1,606 |
$35K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
2,290 |
2,153 |
$30K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,811 |
2,793 |
$26K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
10,837 |
10,363 |
$17K |
| 82947 |
|
6,213 |
5,950 |
$15K |
| H0001 |
Alcohol and/or drug assessment |
11,623 |
11,135 |
$13K |
| 94010 |
|
484 |
481 |
$12K |
| 90750 |
|
77 |
77 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
424 |
422 |
$10K |
| 3078F |
|
9,829 |
9,436 |
$8K |
| 3074F |
|
9,317 |
8,905 |
$8K |
| 90756 |
|
1,225 |
1,223 |
$7K |
| 0011A |
|
166 |
166 |
$6K |
| 0012A |
|
126 |
126 |
$5K |
| 90688 |
|
342 |
342 |
$5K |
| 3079F |
|
3,793 |
3,679 |
$4K |
| 99397 |
|
504 |
502 |
$4K |
| 90674 |
|
339 |
338 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
11,603 |
11,032 |
$3K |
| 96127 |
|
7,927 |
7,607 |
$3K |
| 3077F |
|
1,979 |
1,917 |
$3K |
| 90677 |
|
22 |
22 |
$3K |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
1,536 |
1,509 |
$3K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
672 |
658 |
$3K |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
16,057 |
15,297 |
$3K |
| 3075F |
|
2,535 |
2,489 |
$2K |
| 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) |
3,449 |
3,339 |
$2K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
211 |
209 |
$2K |
| 97802 |
|
1,800 |
1,771 |
$2K |
| 99497 |
|
39 |
39 |
$2K |
| 0064A |
|
67 |
67 |
$2K |
| 97803 |
|
1,830 |
1,799 |
$2K |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
147 |
147 |
$2K |
| 99386 |
|
156 |
156 |
$2K |
| 99442 |
|
107 |
105 |
$2K |
| 1159F |
|
13,495 |
12,771 |
$2K |
| 99496 |
|
32 |
27 |
$2K |
| 1160F |
|
14,400 |
13,620 |
$1K |
| 1126F |
|
8,460 |
8,141 |
$1K |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
1,582 |
1,578 |
$1K |
| 90658 |
|
318 |
318 |
$1K |
| 99401 |
|
611 |
607 |
$1K |
| 3048F |
|
4,419 |
4,279 |
$964.00 |
| 94762 |
|
1,473 |
1,433 |
$861.07 |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
628 |
627 |
$837.13 |
| 1125F |
|
4,518 |
4,389 |
$831.17 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
308 |
306 |
$823.97 |
| 99385 |
|
64 |
63 |
$705.85 |
| 82270 |
|
2,081 |
2,074 |
$653.96 |
| 3044F |
|
4,216 |
4,107 |
$558.00 |
| A4927 |
Gloves, non-sterile, per 100 |
8,103 |
7,359 |
$544.33 |
| 99000 |
|
8,311 |
7,455 |
$500.00 |
| 3061F |
|
662 |
635 |
$388.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
74 |
74 |
$365.25 |
| 92250 |
|
29 |
29 |
$346.50 |
| 99408 |
|
170 |
162 |
$325.01 |
| 81003 |
|
189 |
186 |
$296.33 |
| A4245 |
Alcohol wipes, per box |
7,379 |
6,854 |
$273.87 |
| 0134A |
|
18 |
18 |
$240.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
24 |
$226.73 |
| 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 |
62 |
60 |
$196.00 |
| 94760 |
|
1,046 |
974 |
$185.18 |
| 86580 |
|
32 |
25 |
$176.01 |
| 82272 |
|
2,070 |
2,063 |
$170.61 |
| 1111F |
|
56 |
53 |
$165.00 |
| 92227 |
|
25 |
25 |
$138.18 |
| 3080F |
|
91 |
90 |
$128.50 |
| G0102 |
Prostate cancer screening; digital rectal examination |
14 |
14 |
$124.26 |
| G2010 |
Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment |
65 |
65 |
$122.41 |
| 3049F |
|
1,686 |
1,646 |
$90.00 |
| A6413 |
Adhesive bandage, first-aid type, any size, each |
6,944 |
6,454 |
$80.12 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
11,053 |
10,626 |
$50.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
9,592 |
9,233 |
$48.00 |
| 3050F |
|
1,729 |
1,673 |
$40.00 |
| 82948 |
|
116 |
101 |
$40.00 |
| G9150 |
National committee for quality assurance - level 3 medical home |
17,313 |
16,464 |
$34.50 |
| A4259 |
Lancets, per box of 100 |
3,437 |
3,300 |
$32.97 |
| G8734 |
Elder maltreatment screen documented as negative, follow-up is not required |
936 |
918 |
$20.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
2,248 |
2,158 |
$20.00 |
| 4293F |
|
8,643 |
8,287 |
$14.00 |
| 1158F |
|
249 |
248 |
$10.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
70 |
68 |
$10.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
6,067 |
5,812 |
$8.00 |
| G8482 |
Influenza immunization administered or previously received |
1,803 |
1,797 |
$6.00 |
| 4274F |
|
1,314 |
1,314 |
$2.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
1,495 |
1,457 |
$2.00 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,453 |
3,327 |
$1.45 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
3,990 |
3,856 |
$1.40 |
| 3008F |
|
13,560 |
12,926 |
$0.87 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
672 |
664 |
$0.80 |
| 4010F |
|
2,889 |
2,773 |
$0.59 |
| 91301 |
|
302 |
284 |
$0.10 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
11,057 |
10,617 |
$0.09 |
| 91313 |
|
17 |
17 |
$0.06 |
| 91306 |
|
50 |
50 |
$0.03 |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
1,954 |
1,948 |
$0.02 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
1,829 |
1,821 |
$0.01 |
| 1000F |
|
9,622 |
9,254 |
$0.00 |
| 4008F |
|
651 |
615 |
$0.00 |
| 4037F |
|
1,055 |
1,055 |
$0.00 |
| 3017F |
|
1,524 |
1,474 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
5,873 |
5,710 |
$0.00 |
| 1036F |
|
9,785 |
9,398 |
$0.00 |
| 2016F |
|
352 |
343 |
$0.00 |
| 3011F |
|
2,294 |
2,229 |
$0.00 |
| 3014F |
|
586 |
565 |
$0.00 |
| 4144F |
|
348 |
340 |
$0.00 |
| 1101F |
|
383 |
379 |
$0.00 |
| 4086F |
|
1,500 |
1,437 |
$0.00 |
| 1220F |
|
1,821 |
1,746 |
$0.00 |
| 3754F |
|
507 |
488 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
136 |
135 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
816 |
797 |
$0.00 |
| 4140F |
|
542 |
532 |
$0.00 |
| 2010F |
|
472 |
426 |
$0.00 |
| 2000F |
|
724 |
666 |
$0.00 |
| 2001F |
|
496 |
450 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
32 |
32 |
$0.00 |
| 1005F |
|
352 |
343 |
$0.00 |
| 1110F |
|
39 |
38 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
39 |
35 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
100 |
100 |
$0.00 |
| 1123F |
|
139 |
139 |
$0.00 |
| 1034F |
|
27 |
26 |
$0.00 |
| 99402 |
|
25 |
24 |
$0.00 |
| 4450F |
|
44 |
43 |
$0.00 |
| S0257 |
Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service) |
27 |
27 |
$0.00 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
32 |
32 |
$0.00 |
| 1033F |
|
3,481 |
3,361 |
$0.00 |
| 4013F |
|
3,191 |
3,076 |
$0.00 |
| 3016F |
|
9,391 |
8,993 |
$0.00 |
| 2028F |
|
152 |
149 |
$0.00 |
| 99421 |
|
139 |
61 |
$0.00 |
| 99001 |
|
54 |
54 |
$0.00 |
| 3725F |
|
9,779 |
9,352 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
1,318 |
1,274 |
$0.00 |
| 0518F |
|
361 |
357 |
$0.00 |
| 0556F |
|
1,283 |
1,234 |
$0.00 |
| G9899 |
Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed |
134 |
133 |
$0.00 |
| G9383 |
Patient received screening for hcv infection within the 12 month reporting period |
891 |
887 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
738 |
717 |
$0.00 |
| 1494F |
|
378 |
375 |
$0.00 |
| 1175F |
|
34 |
34 |
$0.00 |
| 4004F |
|
78 |
78 |
$0.00 |
| G8935 |
Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
1,222 |
1,148 |
$0.00 |
| 1090F |
|
228 |
226 |
$0.00 |
| 3288F |
|
413 |
407 |
$0.00 |
| G9448 |
Patients who were born in the years 1945 to 1965 |
130 |
130 |
$0.00 |
| 3015F |
|
442 |
426 |
$0.00 |
| 3023F |
|
113 |
113 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
828 |
805 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
230 |
220 |
$0.00 |
| 4025F |
|
128 |
122 |
$0.00 |
| 3045F |
|
18 |
17 |
$0.00 |
| 3046F |
|
13 |
12 |
$0.00 |
| G9991 |
Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period |
12 |
12 |
$0.00 |
| G0435 |
Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening |
113 |
113 |
$0.00 |
| 0403T |
|
126 |
61 |
$0.00 |
| 4003F |
|
14 |
14 |
$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 |
30 |
30 |
$0.00 |