| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,692 |
11,822 |
$1.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,337 |
7,630 |
$892K |
| 92552 |
|
4,037 |
4,026 |
$207K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
552 |
537 |
$65K |
| 99173 |
|
3,365 |
3,336 |
$58K |
| 94010 |
|
464 |
463 |
$44K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
321 |
315 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
368 |
366 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,954 |
2,918 |
$36K |
| 36415 |
Collection of venous blood by venipuncture |
6,556 |
6,299 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
351 |
346 |
$34K |
| 11056 |
|
176 |
175 |
$32K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
874 |
654 |
$21K |
| 99385 |
|
133 |
130 |
$17K |
| 90686 |
|
1,105 |
1,085 |
$16K |
| 96160 |
|
384 |
383 |
$13K |
| 95923 |
|
115 |
113 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
110 |
109 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
80 |
77 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
73 |
73 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
432 |
419 |
$7K |
| 11721 |
|
124 |
124 |
$7K |
| 99386 |
|
44 |
41 |
$5K |
| 83655 |
|
333 |
326 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
72 |
72 |
$3K |
| 95924 |
|
38 |
38 |
$3K |
| 96127 |
|
1,677 |
1,670 |
$3K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
112 |
111 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
25 |
$3K |
| 93970 |
|
18 |
14 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
79 |
69 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$1K |
| 3078F |
|
2,717 |
2,258 |
$1K |
| 90656 |
|
112 |
112 |
$1K |
| 99429 |
|
208 |
191 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
828 |
823 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
53 |
37 |
$1K |
| 99406 |
|
15 |
14 |
$1K |
| 3074F |
|
2,509 |
2,043 |
$1K |
| 90734 |
|
27 |
27 |
$901.50 |
| 93923 |
|
12 |
12 |
$833.71 |
| 90674 |
|
42 |
42 |
$788.21 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
168 |
162 |
$746.45 |
| 90688 |
|
30 |
30 |
$643.67 |
| 99442 |
|
13 |
12 |
$551.29 |
| 87634 |
|
21 |
21 |
$454.44 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
13 |
13 |
$400.38 |
| 90672 |
|
32 |
32 |
$353.23 |
| 0004A |
|
35 |
35 |
$294.57 |
| 90633 |
|
12 |
12 |
$260.73 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
25 |
25 |
$236.00 |
| 90480 |
|
20 |
19 |
$200.58 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
7,127 |
5,572 |
$186.07 |
| 90651 |
|
42 |
42 |
$175.70 |
| 0072A |
|
15 |
15 |
$163.80 |
| 0071A |
|
20 |
20 |
$163.80 |
| 81003 |
|
70 |
62 |
$132.54 |
| 90660 |
|
19 |
19 |
$90.16 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
3,926 |
3,085 |
$76.50 |
| 3079F |
|
349 |
302 |
$25.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
33 |
33 |
$15.00 |
| 3077F |
|
144 |
134 |
$12.50 |
| 82962 |
|
25 |
25 |
$11.32 |
| 93000 |
|
12 |
12 |
$3.13 |
| 3008F |
|
34 |
28 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
807 |
710 |
$0.00 |
| 1036F |
|
172 |
142 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
178 |
149 |
$0.00 |
| 3075F |
|
77 |
68 |
$0.00 |
| 91307 |
|
67 |
62 |
$0.00 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
17 |
16 |
$0.00 |
| 3044F |
|
13 |
12 |
$0.00 |
| 94760 |
|
23 |
22 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
2,600 |
2,211 |
$0.00 |
| 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) |
293 |
267 |
$0.00 |
| 1160F |
|
139 |
106 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,394 |
1,128 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
2,585 |
2,222 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
70 |
63 |
$0.00 |
| 3725F |
|
61 |
57 |
$0.00 |
| 1159F |
|
137 |
106 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
80 |
64 |
$0.00 |
| 91300 |
|
59 |
59 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
42 |
38 |
$0.00 |