| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28,741 |
27,528 |
$326K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48,864 |
46,978 |
$294K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,738 |
2,698 |
$91K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19,849 |
18,094 |
$75K |
| 99245 |
|
5,049 |
5,013 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,287 |
4,228 |
$39K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,501 |
3,443 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,066 |
2,991 |
$32K |
| 99205 |
Prolong outpt/office vis |
484 |
482 |
$29K |
| 99383 |
|
820 |
804 |
$27K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,697 |
2,678 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,327 |
1,286 |
$24K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,029 |
2,010 |
$24K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
771 |
765 |
$24K |
| 95886 |
|
1,121 |
1,107 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15,682 |
15,324 |
$16K |
| 97802 |
|
3,654 |
3,535 |
$15K |
| 92552 |
|
12,415 |
12,055 |
$14K |
| 99384 |
|
383 |
374 |
$12K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,662 |
1,613 |
$11K |
| 97803 |
|
15,931 |
15,657 |
$8K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
16,090 |
15,790 |
$8K |
| 99215 |
Prolong outpt/office vis |
443 |
441 |
$6K |
| 96156 |
|
628 |
623 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,269 |
1,492 |
$6K |
| 99382 |
|
270 |
264 |
$5K |
| 99381 |
|
206 |
203 |
$5K |
| 95910 |
|
285 |
283 |
$5K |
| 93000 |
|
2,912 |
2,881 |
$5K |
| 85018 |
|
13,970 |
13,616 |
$4K |
| 90716 |
|
2,810 |
2,736 |
$3K |
| 90707 |
|
2,001 |
1,950 |
$3K |
| 83655 |
|
2,500 |
1,606 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
15,805 |
15,480 |
$3K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,716 |
2,711 |
$3K |
| 99401 |
|
16,045 |
15,713 |
$2K |
| 97750 |
|
154 |
92 |
$2K |
| 90715 |
|
1,377 |
1,335 |
$2K |
| 96111 |
|
824 |
774 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
890 |
623 |
$2K |
| 99173 |
|
11,925 |
11,534 |
$2K |
| 97014 |
|
247 |
106 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
99 |
99 |
$2K |
| 96127 |
|
2,766 |
2,718 |
$2K |
| 3008F |
|
84,303 |
79,191 |
$2K |
| 2010F |
|
93,605 |
87,315 |
$1K |
| 90723 |
|
1,557 |
1,511 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
19 |
$962.35 |
| 95911 |
|
228 |
225 |
$915.60 |
| 1159F |
|
95,774 |
88,852 |
$832.96 |
| 90756 |
|
364 |
326 |
$797.76 |
| 90686 |
|
625 |
543 |
$672.65 |
| 2000F |
|
75,711 |
70,840 |
$535.43 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
16 |
15 |
$492.56 |
| 90648 |
|
221 |
192 |
$487.80 |
| 3074F |
|
57,143 |
53,637 |
$460.27 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,274 |
4,004 |
$445.87 |
| 90670 |
|
221 |
188 |
$406.91 |
| 90744 |
|
505 |
493 |
$402.41 |
| 90713 |
|
477 |
468 |
$384.66 |
| 90633 |
|
228 |
209 |
$379.08 |
| 90700 |
|
158 |
152 |
$293.79 |
| 90672 |
|
398 |
390 |
$271.08 |
| 99385 |
|
17 |
17 |
$269.69 |
| 99397 |
|
42 |
41 |
$261.77 |
| 90696 |
|
302 |
292 |
$230.87 |
| 90688 |
|
82 |
80 |
$218.58 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
657 |
322 |
$211.04 |
| 1125F |
|
17,666 |
17,073 |
$188.24 |
| 97124 |
|
296 |
122 |
$156.73 |
| 80305 |
|
456 |
443 |
$155.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,260 |
1,237 |
$146.16 |
| 3078F |
|
55,227 |
51,892 |
$144.94 |
| 2001F |
|
84,986 |
79,090 |
$142.08 |
| 4037F |
|
773 |
752 |
$140.65 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
239 |
106 |
$138.50 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
545 |
523 |
$129.23 |
| 4001F |
|
1,554 |
1,539 |
$124.05 |
| 90658 |
|
22 |
21 |
$121.74 |
| 69210 |
|
84 |
79 |
$119.99 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
50 |
39 |
$114.04 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
73 |
72 |
$95.65 |
| J3490 |
Unclassified drugs |
169 |
120 |
$90.70 |
| 3077F |
|
15,099 |
14,522 |
$81.40 |
| 90698 |
|
20 |
20 |
$54.27 |
| 90649 |
|
55 |
52 |
$45.00 |
| 90734 |
|
38 |
37 |
$36.00 |
| 90661 |
|
38 |
38 |
$32.20 |
| 81002 |
|
572 |
539 |
$30.63 |
| 3075F |
|
8,578 |
8,306 |
$26.64 |
| 3280F |
|
2,142 |
2,141 |
$23.12 |
| 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) |
55 |
50 |
$16.85 |
| 1160F |
|
45,299 |
43,100 |
$15.19 |
| 36416 |
|
338 |
338 |
$12.94 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
106 |
103 |
$12.45 |
| 94760 |
|
102 |
102 |
$10.04 |
| 80061 |
Lipid panel |
107 |
105 |
$9.14 |
| 1036F |
|
25,515 |
24,854 |
$7.50 |
| 82962 |
|
328 |
322 |
$7.46 |
| 4058F |
|
13,451 |
13,378 |
$5.25 |
| 86580 |
|
118 |
118 |
$3.35 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
18,928 |
18,128 |
$0.78 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
16,558 |
15,862 |
$0.78 |
| 3079F |
|
16,382 |
15,808 |
$0.01 |
| 3281F |
|
17 |
17 |
$0.00 |
| 1126F |
|
7,217 |
7,035 |
$0.00 |
| 3351F |
|
2,394 |
2,389 |
$0.00 |
| 1101F |
|
114 |
114 |
$0.00 |
| 3080F |
|
9,043 |
8,776 |
$0.00 |
| 1038F |
|
30 |
30 |
$0.00 |
| 3044F |
|
143 |
143 |
$0.00 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
669 |
667 |
$0.00 |
| 1157F |
|
232 |
231 |
$0.00 |
| 1000F |
|
3,099 |
3,027 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
1,797 |
1,767 |
$0.00 |
| 4140F |
|
1,043 |
989 |
$0.00 |
| 10010 |
|
14 |
14 |
$0.00 |
| 3120F |
|
501 |
499 |
$0.00 |
| 3279F |
|
3,112 |
3,110 |
$0.00 |
| 4000F |
|
873 |
868 |
$0.00 |
| 1034F |
|
807 |
783 |
$0.00 |
| 3754F |
|
138 |
138 |
$0.00 |
| 4149F |
|
257 |
257 |
$0.00 |
| 2015F |
|
54 |
54 |
$0.00 |
| 1170F |
|
88 |
88 |
$0.00 |
| 1035F |
|
740 |
732 |
$0.00 |
| 3011F |
|
101 |
101 |
$0.00 |
| 1030F |
|
349 |
349 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
156 |
154 |
$0.00 |
| 1123F |
|
90 |
90 |
$0.00 |
| 3353F |
|
24 |
24 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
43 |
43 |
$0.00 |
| 3510F |
|
143 |
143 |
$0.00 |
| 90674 |
|
20 |
20 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
29 |
29 |
$0.00 |
| 90656 |
|
17 |
17 |
$0.00 |
| 1010F |
|
19 |
19 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
3,241 |
3,168 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,322 |
1,240 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
1,328 |
1,244 |
$0.00 |
| 0518F |
|
80 |
80 |
$0.00 |
| 3288F |
|
629 |
626 |
$0.00 |
| 4035F |
|
1,206 |
1,203 |
$0.00 |
| 4158F |
|
656 |
636 |
$0.00 |
| 1032F |
|
49 |
49 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
686 |
674 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
185 |
185 |
$0.00 |
| 4004F |
|
218 |
218 |
$0.00 |
| 2028F |
|
161 |
159 |
$0.00 |
| 1158F |
|
285 |
284 |
$0.00 |
| 2014F |
|
153 |
152 |
$0.00 |
| 90473 |
|
107 |
107 |
$0.00 |
| 4274F |
|
350 |
350 |
$0.00 |
| 3050F |
|
77 |
77 |
$0.00 |
| 4012F |
|
143 |
143 |
$0.00 |
| 1090F |
|
15 |
15 |
$0.00 |
| J1071 |
Injection, testosterone cypionate, 1 mg |
22 |
12 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 17110 |
|
12 |
12 |
$0.00 |
| 0556F |
|
102 |
102 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
34 |
$0.00 |
| 3046F |
|
162 |
162 |
$0.00 |