| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,873 |
18,717 |
$270K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
3,051 |
3,047 |
$85K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
6,669 |
6,577 |
$51K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,574 |
1,520 |
$42K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,606 |
1,605 |
$37K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
610 |
608 |
$14K |
| 99401 |
|
4,133 |
4,113 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,048 |
1,042 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
506 |
504 |
$11K |
| H0001 |
Alcohol and/or drug assessment |
11,000 |
10,308 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
455 |
454 |
$10K |
| 90686 |
|
719 |
719 |
$8K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
352 |
352 |
$8K |
| 93000 |
|
417 |
412 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
303 |
300 |
$5K |
| 90682 |
|
100 |
100 |
$5K |
| 99406 |
|
749 |
674 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
186 |
186 |
$4K |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
2,109 |
2,068 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
9,789 |
9,653 |
$4K |
| 3074F |
|
2,156 |
2,033 |
$3K |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
10,815 |
10,103 |
$3K |
| G0008 |
Administration of influenza virus vaccine |
396 |
395 |
$2K |
| 3079F |
|
1,489 |
1,409 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
215 |
212 |
$2K |
| 99442 |
|
137 |
125 |
$2K |
| 3078F |
|
1,512 |
1,441 |
$2K |
| S9452 |
Nutrition classes, non-physician provider, per session |
5,164 |
4,742 |
$2K |
| S9451 |
Exercise classes, non-physician provider, per session |
6,795 |
6,204 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
297 |
291 |
$2K |
| 99385 |
|
76 |
76 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,035 |
4,845 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
56 |
56 |
$2K |
| 1126F |
|
7,568 |
6,844 |
$1K |
| 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 |
3,118 |
3,101 |
$1K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
445 |
409 |
$1K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
74 |
69 |
$1K |
| 3077F |
|
455 |
434 |
$968.00 |
| 3075F |
|
554 |
535 |
$825.50 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
57 |
56 |
$822.01 |
| 99397 |
|
34 |
34 |
$802.74 |
| 90674 |
|
53 |
53 |
$747.75 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
34 |
34 |
$449.97 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
997 |
944 |
$444.50 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
31 |
$421.51 |
| 1160F |
|
6,538 |
5,813 |
$409.62 |
| 3080F |
|
176 |
169 |
$403.00 |
| 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) |
638 |
627 |
$330.50 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
5,218 |
5,165 |
$314.00 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
829 |
829 |
$278.10 |
| 1170F |
|
194 |
181 |
$265.00 |
| 1125F |
|
1,069 |
1,021 |
$259.01 |
| 90734 |
|
92 |
92 |
$255.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
346 |
343 |
$229.75 |
| G9621 |
Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling |
213 |
201 |
$211.25 |
| 0011A |
|
12 |
12 |
$199.90 |
| 1159F |
|
1,822 |
1,808 |
$170.00 |
| S9470 |
Nutritional counseling, dietitian visit |
52 |
52 |
$160.00 |
| 3061F |
|
767 |
725 |
$150.00 |
| 3044F |
|
486 |
464 |
$140.00 |
| 90688 |
|
59 |
59 |
$109.83 |
| 3048F |
|
1,027 |
973 |
$108.00 |
| 90658 |
|
45 |
45 |
$86.36 |
| S9449 |
Weight management classes, non-physician provider, per session |
345 |
345 |
$70.00 |
| 3049F |
|
536 |
513 |
$50.00 |
| 94760 |
|
2,450 |
2,206 |
$40.58 |
| G0435 |
Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening |
894 |
894 |
$39.96 |
| 90715 |
|
15 |
15 |
$39.00 |
| G9508 |
Documentation that the patient is not on a statin medication |
13 |
13 |
$37.50 |
| 3045F |
|
208 |
194 |
$20.05 |
| 3050F |
|
501 |
481 |
$20.00 |
| 0521F |
|
151 |
148 |
$20.00 |
| 87270 |
|
16 |
16 |
$16.06 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
341 |
340 |
$15.62 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
3,941 |
3,537 |
$15.00 |
| 1111F |
|
80 |
77 |
$10.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
6,359 |
5,931 |
$8.89 |
| 3008F |
|
15,921 |
14,103 |
$0.42 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
3,860 |
3,473 |
$0.00 |
| 4293F |
|
4,723 |
4,601 |
$0.00 |
| 1000F |
|
9,805 |
9,152 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
3,040 |
2,757 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
7,860 |
7,300 |
$0.00 |
| 1036F |
|
8,475 |
7,946 |
$0.00 |
| 3017F |
|
1,155 |
1,075 |
$0.00 |
| 3014F |
|
567 |
530 |
$0.00 |
| 2010F |
|
2,669 |
2,655 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,997 |
2,840 |
$0.00 |
| 3011F |
|
651 |
638 |
$0.00 |
| 4000F |
|
249 |
228 |
$0.00 |
| 1034F |
|
1,235 |
1,136 |
$0.00 |
| 1123F |
|
261 |
261 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
757 |
711 |
$0.00 |
| 90651 |
|
144 |
144 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
46 |
45 |
$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) |
41 |
41 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
126 |
121 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
325 |
322 |
$0.00 |
| 2000F |
|
12 |
12 |
$0.00 |
| 2016F |
|
13 |
13 |
$0.00 |
| G8542 |
Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required |
123 |
119 |
$0.00 |
| 2015F |
|
13 |
13 |
$0.00 |
| 81528 |
Oncology (colorectal) screening, quantitative real-time target and signal amplification |
32 |
32 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
13 |
13 |
$0.00 |
| G9150 |
National committee for quality assurance - level 3 medical home |
10,575 |
9,375 |
$0.00 |
| 3016F |
|
9,624 |
8,994 |
$0.00 |
| 4004F |
|
1,516 |
1,416 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
950 |
941 |
$0.00 |
| G9383 |
Patient received screening for hcv infection within the 12 month reporting period |
380 |
379 |
$0.00 |
| 3725F |
|
6,211 |
6,067 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
504 |
502 |
$0.00 |
| 0556F |
|
1,617 |
1,581 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
2,816 |
2,686 |
$0.00 |
| 1158F |
|
462 |
448 |
$0.00 |
| G9276 |
Documentation that patient is a current tobacco user |
1,098 |
995 |
$0.00 |
| 3015F |
|
1,204 |
1,125 |
$0.00 |
| 2022F |
|
159 |
143 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
675 |
668 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
179 |
165 |
$0.00 |
| 2028F |
|
193 |
190 |
$0.00 |
| 3288F |
|
212 |
195 |
$0.00 |
| 1494F |
|
153 |
139 |
$0.00 |
| 1090F |
|
195 |
180 |
$0.00 |
| 3046F |
|
63 |
57 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
63 |
63 |
$0.00 |
| 90649 |
|
12 |
12 |
$0.00 |
| 90461 |
|
27 |
27 |
$0.00 |
| G9448 |
Patients who were born in the years 1945 to 1965 |
62 |
62 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
77 |
77 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
47 |
47 |
$0.00 |
| 4013F |
|
13 |
13 |
$0.00 |
| G8442 |
Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter |
26 |
26 |
$0.00 |
| 4025F |
|
15 |
15 |
$0.00 |