| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,134 |
5,418 |
$65K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,564 |
1,390 |
$52K |
| 99401 |
|
7,781 |
6,546 |
$38K |
| 86328 |
|
1,068 |
1,020 |
$21K |
| 99442 |
|
2,049 |
1,870 |
$19K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,478 |
2,246 |
$19K |
| 86769 |
|
749 |
709 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,984 |
1,829 |
$12K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
981 |
981 |
$11K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
7,060 |
5,723 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
720 |
719 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
408 |
408 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
376 |
370 |
$5K |
| 99443 |
|
686 |
639 |
$5K |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
174 |
149 |
$3K |
| H0001 |
Alcohol and/or drug assessment |
3,069 |
3,033 |
$3K |
| 99402 |
|
442 |
422 |
$3K |
| 0012A |
|
64 |
64 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
74 |
74 |
$2K |
| 0011A |
|
58 |
58 |
$2K |
| 0064A |
|
54 |
54 |
$2K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
183 |
163 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
5,410 |
5,241 |
$2K |
| 93000 |
|
100 |
100 |
$2K |
| 99215 |
Prolong outpt/office vis |
24 |
22 |
$1K |
| 3074F |
|
1,251 |
1,203 |
$1K |
| 85013 |
|
253 |
252 |
$1K |
| 3078F |
|
1,071 |
1,023 |
$1K |
| 92551 |
|
406 |
405 |
$947.32 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$868.90 |
| H0049 |
Alcohol and/or drug screening |
256 |
238 |
$818.00 |
| 99407 |
|
30 |
24 |
$788.47 |
| 97802 |
|
1,058 |
985 |
$654.82 |
| 99385 |
|
25 |
25 |
$611.89 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
50 |
50 |
$569.87 |
| 85018 |
|
246 |
245 |
$524.76 |
| 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 |
103 |
103 |
$522.61 |
| 1126F |
|
3,353 |
2,850 |
$437.43 |
| 1159F |
|
4,408 |
3,590 |
$390.00 |
| 81000 |
|
261 |
252 |
$329.18 |
| 99173 |
|
157 |
157 |
$300.00 |
| 99406 |
|
56 |
48 |
$273.75 |
| 1160F |
|
2,685 |
2,601 |
$197.53 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
274 |
271 |
$84.63 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
3,218 |
3,154 |
$44.07 |
| 87320 |
|
55 |
53 |
$40.15 |
| 90686 |
|
197 |
195 |
$38.08 |
| 80061 |
Lipid panel |
14 |
14 |
$23.98 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
17 |
17 |
$23.64 |
| 3077F |
|
26 |
26 |
$22.50 |
| 90656 |
|
84 |
84 |
$19.77 |
| 3079F |
|
115 |
110 |
$17.51 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
12 |
12 |
$15.79 |
| 99000 |
|
3,989 |
3,789 |
$4.50 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
6,555 |
5,592 |
$0.64 |
| 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) |
210 |
181 |
$0.57 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
209 |
180 |
$0.57 |
| 3008F |
|
5,100 |
4,269 |
$0.36 |
| 91306 |
|
39 |
39 |
$0.04 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
2,585 |
2,380 |
$0.03 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,677 |
2,458 |
$0.03 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
6,043 |
5,084 |
$0.02 |
| 3049F |
|
38 |
37 |
$0.02 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
1,869 |
1,579 |
$0.01 |
| 91301 |
|
128 |
127 |
$0.01 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
649 |
649 |
$0.00 |
| 97803 |
|
755 |
755 |
$0.00 |
| 3725F |
|
4,764 |
3,952 |
$0.00 |
| 3050F |
|
161 |
158 |
$0.00 |
| G0435 |
Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening |
38 |
38 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
209 |
196 |
$0.00 |
| 3016F |
|
2,393 |
2,349 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
292 |
255 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
79 |
79 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
2,541 |
2,516 |
$0.00 |
| 99001 |
|
627 |
610 |
$0.00 |
| 1033F |
|
1,093 |
1,091 |
$0.00 |
| 0556F |
|
751 |
713 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,039 |
1,685 |
$0.00 |
| 1026F |
|
24 |
24 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
2,080 |
1,895 |
$0.00 |
| G8935 |
Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
168 |
133 |
$0.00 |
| 2025F |
|
12 |
12 |
$0.00 |
| S0316 |
Disease management program, follow-up/reassessment |
33 |
33 |
$0.00 |
| G8976 |
Most recent hemoglobin (hgb) level >= 10 g/dl |
67 |
67 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
34 |
31 |
$0.00 |
| 0521F |
|
63 |
62 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
231 |
193 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
244 |
203 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
78 |
67 |
$0.00 |
| G9150 |
National committee for quality assurance - level 3 medical home |
124 |
122 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
53 |
53 |
$0.00 |
| 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) |
146 |
136 |
$0.00 |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
76 |
71 |
$0.00 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
12 |
12 |
$0.00 |
| 4004F |
|
17 |
17 |
$0.00 |
| 1039F |
|
26 |
24 |
$0.00 |
| 4013F |
|
40 |
34 |
$0.00 |
| 1158F |
|
16 |
16 |
$0.00 |
| 77062 |
|
12 |
12 |
$0.00 |
| G0143 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision |
13 |
13 |
$0.00 |
| G9276 |
Documentation that patient is a current tobacco user |
30 |
25 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
3,159 |
2,617 |
$0.00 |
| 4293F |
|
2,201 |
2,177 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
2,954 |
2,923 |
$0.00 |
| 4290F |
|
1,430 |
1,418 |
$0.00 |
| 2001F |
|
4,348 |
3,699 |
$0.00 |
| 1220F |
|
3,709 |
3,165 |
$0.00 |
| G9273 |
Blood pressure has a systolic value of < 140 and a diastolic value of < 90 |
2,103 |
1,989 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
2,222 |
2,203 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
695 |
695 |
$0.00 |
| 3011F |
|
846 |
796 |
$0.00 |
| 1000F |
|
2,438 |
2,357 |
$0.00 |
| 1036F |
|
5,178 |
4,188 |
$0.00 |
| 2010F |
|
2,404 |
2,360 |
$0.00 |
| 2000F |
|
4,269 |
3,632 |
$0.00 |
| G9228 |
Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) |
29 |
29 |
$0.00 |
| 0001F |
|
510 |
468 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
261 |
230 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
348 |
335 |
$0.00 |
| G9274 |
Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90 |
144 |
134 |
$0.00 |
| G9432 |
Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented |
123 |
113 |
$0.00 |
| 96127 |
|
44 |
44 |
$0.00 |
| 3017F |
|
42 |
41 |
$0.00 |
| 2015F |
|
54 |
48 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
46 |
38 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
62 |
52 |
$0.00 |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
38 |
38 |
$0.00 |
| 2016F |
|
54 |
48 |
$0.00 |
| 2023F |
|
12 |
12 |
$0.00 |
| 1005F |
|
54 |
48 |
$0.00 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
14 |
14 |
$0.00 |
| 2033F |
|
12 |
12 |
$0.00 |
| 3080F |
|
56 |
54 |
$0.00 |
| 3048F |
|
15 |
14 |
$0.00 |
| 3075F |
|
17 |
14 |
$0.00 |
| 1123F |
|
18 |
18 |
$0.00 |
| 3072F |
|
12 |
12 |
$0.00 |
| 0513F |
|
13 |
12 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
12 |
12 |
$0.00 |