| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0129 |
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
759 |
485 |
$1.05M |
| J0717 |
Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
766 |
423 |
$1.01M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,768 |
2,864 |
$260K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
262 |
160 |
$217K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,081 |
6,045 |
$174K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,789 |
2,387 |
$52K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
10,379 |
7,835 |
$38K |
| 86140 |
|
10,815 |
8,144 |
$26K |
| 99215 |
Prolong outpt/office vis |
457 |
389 |
$21K |
| 85651 |
|
10,865 |
8,188 |
$19K |
| 96415 |
|
1,300 |
727 |
$17K |
| 84460 |
|
7,003 |
5,142 |
$15K |
| 82565 |
|
6,929 |
5,097 |
$15K |
| 82040 |
|
6,918 |
5,082 |
$14K |
| 80053 |
Comprehensive metabolic panel |
2,373 |
1,850 |
$14K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
468 |
324 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
136 |
121 |
$8K |
| 84450 |
|
1,841 |
1,534 |
$5K |
| 84550 |
|
1,194 |
900 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
995 |
539 |
$2K |
| 96401 |
|
62 |
31 |
$2K |
| 86225 |
|
251 |
194 |
$2K |
| 99000 |
|
811 |
643 |
$1K |
| 86038 |
|
169 |
141 |
$1K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
1,318 |
1,119 |
$1K |
| 86200 |
|
122 |
104 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
93 |
74 |
$1K |
| 86160 |
|
220 |
82 |
$932.96 |
| 86431 |
|
182 |
155 |
$711.51 |
| 82570 |
|
303 |
228 |
$565.30 |
| 84156 |
|
303 |
228 |
$396.14 |
| 36415 |
Collection of venous blood by venipuncture |
7,026 |
5,745 |
$392.55 |
| 83970 |
|
16 |
15 |
$319.93 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
80 |
67 |
$316.76 |
| 82550 |
|
18 |
12 |
$58.42 |
| 82310 |
|
41 |
31 |
$45.77 |
| 81003 |
|
66 |
43 |
$43.00 |
| 1036F |
|
1,148 |
952 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
209 |
157 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
848 |
718 |
$0.00 |
| 1006F |
|
14 |
13 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
16 |
13 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
580 |
476 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,638 |
1,309 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,195 |
993 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
139 |
119 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
56 |
42 |
$0.00 |