| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
320,402 |
266,656 |
$18.27M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
258,263 |
219,555 |
$12.44M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
11,464 |
11,373 |
$986K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
9,761 |
9,576 |
$816K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25,811 |
25,223 |
$810K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
10,366 |
10,275 |
$800K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
9,897 |
9,732 |
$796K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
8,200 |
7,607 |
$688K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13,131 |
11,919 |
$453K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,970 |
5,847 |
$399K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,534 |
4,475 |
$341K |
| 36415 |
Collection of venous blood by venipuncture |
111,934 |
106,133 |
$296K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18,667 |
16,580 |
$263K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,069 |
10,660 |
$223K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
8,922 |
7,685 |
$209K |
| 90686 |
|
19,755 |
18,346 |
$167K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13,870 |
12,627 |
$141K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,929 |
1,884 |
$132K |
| 99385 |
|
1,226 |
1,149 |
$111K |
| 0012A |
|
2,290 |
2,257 |
$92K |
| 0011A |
|
2,335 |
2,290 |
$80K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,052 |
4,909 |
$71K |
| 0064A |
|
1,182 |
1,138 |
$63K |
| 0002A |
|
906 |
902 |
$60K |
| 0001A |
|
977 |
971 |
$57K |
| 81002 |
|
21,413 |
19,208 |
$51K |
| 0072A |
|
623 |
604 |
$48K |
| 0071A |
|
659 |
617 |
$48K |
| 99215 |
Prolong outpt/office vis |
968 |
766 |
$39K |
| 99386 |
|
333 |
308 |
$36K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
434 |
421 |
$33K |
| 93000 |
|
2,898 |
2,666 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
779 |
746 |
$26K |
| 76770 |
|
456 |
441 |
$26K |
| 90656 |
|
1,140 |
1,030 |
$25K |
| 99173 |
|
19,772 |
18,800 |
$23K |
| 90662 |
|
2,707 |
2,454 |
$22K |
| 99000 |
|
15,087 |
13,514 |
$22K |
| 0054A |
|
268 |
267 |
$19K |
| 0052A |
|
231 |
227 |
$18K |
| 81025 |
|
2,771 |
2,543 |
$16K |
| 92228 |
|
645 |
642 |
$15K |
| 99383 |
|
190 |
183 |
$15K |
| 99384 |
|
137 |
135 |
$14K |
| 0004A |
|
207 |
199 |
$13K |
| 99442 |
|
458 |
381 |
$13K |
| 99397 |
|
816 |
791 |
$12K |
| 96127 |
|
2,887 |
2,854 |
$12K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,581 |
2,283 |
$11K |
| 0051A |
|
128 |
126 |
$10K |
| 99188 |
|
837 |
818 |
$9K |
| 99443 |
|
234 |
200 |
$9K |
| G0180 |
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
314 |
309 |
$7K |
| 0134A |
|
152 |
148 |
$7K |
| 0031A |
|
114 |
114 |
$6K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
81 |
81 |
$6K |
| 0053A |
|
78 |
78 |
$6K |
| 87428 |
|
97 |
94 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,036 |
2,669 |
$5K |
| 76536 |
|
63 |
60 |
$5K |
| 0124A |
|
73 |
72 |
$4K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
116 |
112 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,174 |
1,968 |
$3K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
116 |
112 |
$3K |
| 94760 |
|
5,553 |
4,118 |
$3K |
| 90682 |
|
163 |
132 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
391 |
354 |
$2K |
| 95911 |
|
16 |
13 |
$2K |
| 99439 |
|
217 |
210 |
$2K |
| 83014 |
|
443 |
412 |
$2K |
| 86328 |
|
118 |
85 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
88 |
86 |
$2K |
| 94761 |
|
2,129 |
1,554 |
$2K |
| 92250 |
|
73 |
55 |
$2K |
| 0013A |
|
43 |
43 |
$1K |
| 82962 |
|
1,385 |
1,092 |
$1K |
| 0034A |
|
15 |
15 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
1,272 |
1,146 |
$1K |
| 90670 |
|
982 |
915 |
$962.11 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
30 |
30 |
$851.65 |
| 99382 |
|
12 |
12 |
$810.86 |
| 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) |
166 |
154 |
$687.79 |
| 95117 |
|
107 |
30 |
$677.24 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
906 |
667 |
$662.30 |
| 81003 |
|
584 |
486 |
$637.43 |
| 99490 |
Ccm add 20min |
653 |
644 |
$507.64 |
| 90734 |
|
893 |
834 |
$441.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
132 |
127 |
$407.68 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
380 |
272 |
$305.88 |
| 90715 |
|
490 |
469 |
$300.66 |
| 90688 |
|
360 |
331 |
$298.98 |
| G0008 |
Administration of influenza virus vaccine |
2,627 |
2,356 |
$280.59 |
| 76882 |
|
14 |
13 |
$260.62 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
45 |
42 |
$251.22 |
| 90651 |
|
1,924 |
1,807 |
$239.14 |
| 86580 |
|
14 |
13 |
$108.86 |
| 90633 |
|
448 |
430 |
$102.67 |
| 69209 |
|
16 |
12 |
$68.97 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
848 |
796 |
$46.92 |
| 3008F |
|
29,372 |
25,985 |
$7.76 |
| A7015 |
Aerosol mask, used with dme nebulizer |
14 |
12 |
$7.56 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
13 |
12 |
$4.60 |
| 3078F |
|
16,090 |
11,519 |
$3.24 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
29,169 |
19,721 |
$3.12 |
| 1159F |
|
30,286 |
21,172 |
$3.03 |
| 1160F |
|
30,049 |
21,121 |
$3.03 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
6,721 |
4,439 |
$3.02 |
| 4010F |
|
6,444 |
5,338 |
$1.54 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
14,426 |
9,871 |
$0.89 |
| 91307 |
|
216 |
193 |
$0.77 |
| 4013F |
|
6,915 |
5,775 |
$0.69 |
| 91305 |
|
72 |
67 |
$0.38 |
| 3077F |
|
3,009 |
2,252 |
$0.32 |
| 91300 |
|
466 |
405 |
$0.25 |
| 91301 |
|
1,103 |
995 |
$0.22 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
2,541 |
1,867 |
$0.21 |
| 91313 |
|
63 |
61 |
$0.16 |
| 3074F |
|
9,023 |
6,725 |
$0.15 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
8,691 |
6,104 |
$0.13 |
| 91306 |
|
158 |
135 |
$0.10 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
11,430 |
7,989 |
$0.08 |
| 1036F |
|
1,207 |
1,120 |
$0.06 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
229 |
196 |
$0.05 |
| 3079F |
|
2,082 |
1,679 |
$0.04 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,267 |
858 |
$0.04 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
8,424 |
5,862 |
$0.02 |
| 91312 |
|
14 |
14 |
$0.02 |
| 1123F |
|
434 |
336 |
$0.01 |
| 3075F |
|
2,082 |
1,622 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
485 |
382 |
$0.00 |
| 90620 |
|
455 |
430 |
$0.00 |
| 3048F |
|
988 |
777 |
$0.00 |
| 3044F |
|
924 |
707 |
$0.00 |
| G8422 |
Bmi not documented, documentation the patient is not eligible for bmi calculation |
2,839 |
2,332 |
$0.00 |
| G8473 |
Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed |
385 |
324 |
$0.00 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
1,830 |
1,534 |
$0.00 |
| 90680 |
|
177 |
157 |
$0.00 |
| G9745 |
Documented reason for not screening or recommending a follow-up for high blood pressure |
256 |
211 |
$0.00 |
| 3049F |
|
224 |
187 |
$0.00 |
| 90716 |
|
421 |
406 |
$0.00 |
| 1170F |
|
62 |
61 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
19 |
19 |
$0.00 |
| 1006F |
|
212 |
135 |
$0.00 |
| 90744 |
|
97 |
90 |
$0.00 |
| 90619 |
|
278 |
261 |
$0.00 |
| 90698 |
|
292 |
268 |
$0.00 |
| 3017F |
|
98 |
91 |
$0.00 |
| 3080F |
|
48 |
42 |
$0.00 |
| 1126F |
|
38 |
30 |
$0.00 |
| 3014F |
|
45 |
39 |
$0.00 |
| 1101F |
|
71 |
57 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
23 |
21 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
2,061 |
1,557 |
$0.00 |
| 90707 |
|
387 |
365 |
$0.00 |
| 90700 |
|
38 |
38 |
$0.00 |
| 0521F |
|
23 |
12 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
39 |
25 |
$0.00 |
| G8421 |
Bmi not documented and no reason is given |
234 |
197 |
$0.00 |
| 3050F |
|
48 |
41 |
$0.00 |
| 3046F |
|
32 |
25 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
91 |
83 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
54 |
35 |
$0.00 |
| 3288F |
|
76 |
63 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
27 |
25 |
$0.00 |
| 90685 |
|
15 |
15 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
23 |
13 |
$0.00 |
| 4040F |
|
50 |
41 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
38 |
28 |
$0.00 |
| 3045F |
|
22 |
14 |
$0.00 |
| 3051F |
|
14 |
13 |
$0.00 |