| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42,525 |
37,546 |
$2.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,562 |
12,622 |
$1.02M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14,854 |
14,652 |
$335K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,915 |
2,912 |
$207K |
| 92587 |
|
11,211 |
11,195 |
$182K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,548 |
4,538 |
$169K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,794 |
4,785 |
$163K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,323 |
3,303 |
$144K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,798 |
2,734 |
$135K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,656 |
2,656 |
$133K |
| H0001 |
Alcohol and/or drug assessment |
31,247 |
27,194 |
$120K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,688 |
3,603 |
$88K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
30,062 |
26,109 |
$78K |
| 90461 |
|
3,605 |
3,597 |
$71K |
| 94010 |
|
2,655 |
2,600 |
$69K |
| 93000 |
|
5,128 |
5,054 |
$65K |
| 92015 |
Determination of refractive state |
11,464 |
11,450 |
$46K |
| 99460 |
|
295 |
293 |
$21K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
675 |
654 |
$20K |
| 99215 |
Prolong outpt/office vis |
136 |
132 |
$19K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,524 |
808 |
$19K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
293 |
291 |
$16K |
| 92557 |
|
399 |
398 |
$13K |
| 90671 |
|
494 |
494 |
$10K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
151 |
87 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,170 |
1,148 |
$10K |
| 83655 |
|
566 |
563 |
$6K |
| 3079F |
|
7,429 |
6,764 |
$5K |
| 3075F |
|
6,912 |
6,312 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
814 |
798 |
$4K |
| 90670 |
|
1,383 |
1,382 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
313 |
310 |
$4K |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
22,622 |
19,247 |
$4K |
| H0049 |
Alcohol and/or drug screening |
2,025 |
1,726 |
$4K |
| 99401 |
|
187 |
186 |
$4K |
| 3074F |
|
8,085 |
6,808 |
$4K |
| 3078F |
|
8,233 |
6,942 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
21,473 |
20,363 |
$3K |
| 90688 |
|
1,390 |
1,385 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,031 |
997 |
$2K |
| 90474 |
|
236 |
236 |
$2K |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
20,324 |
17,720 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
158 |
157 |
$1K |
| 90620 |
|
1,191 |
1,187 |
$1K |
| 1111F |
|
879 |
776 |
$1K |
| 90633 |
|
1,168 |
1,167 |
$974.19 |
| 99397 |
|
38 |
38 |
$788.56 |
| 81002 |
|
431 |
419 |
$745.74 |
| 92250 |
|
84 |
84 |
$723.35 |
| 94060 |
|
15 |
15 |
$712.22 |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
4,787 |
4,715 |
$702.47 |
| 90662 |
|
17 |
16 |
$655.12 |
| 90716 |
|
836 |
836 |
$624.00 |
| 90707 |
|
730 |
729 |
$600.00 |
| 90734 |
|
1,002 |
1,001 |
$595.00 |
| 1160F |
|
9,680 |
8,791 |
$580.00 |
| 1126F |
|
11,071 |
9,990 |
$577.00 |
| 90648 |
|
1,330 |
1,329 |
$575.00 |
| 90723 |
|
583 |
583 |
$550.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
48 |
48 |
$540.00 |
| 99462 |
|
14 |
14 |
$539.46 |
| 3077F |
|
841 |
769 |
$534.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
27 |
27 |
$489.58 |
| 92650 |
|
33 |
33 |
$426.44 |
| 90651 |
|
1,510 |
1,510 |
$412.55 |
| 1170F |
|
524 |
470 |
$370.00 |
| 90756 |
|
17 |
17 |
$368.18 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36 |
36 |
$343.27 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
92 |
91 |
$330.70 |
| 90473 |
|
1,017 |
1,017 |
$292.83 |
| 99402 |
|
16 |
16 |
$252.00 |
| 90700 |
|
698 |
698 |
$250.00 |
| 90744 |
|
116 |
116 |
$240.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
12,799 |
11,118 |
$236.54 |
| 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) |
2,383 |
2,149 |
$226.50 |
| 86580 |
|
42 |
42 |
$198.28 |
| 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 |
39 |
39 |
$190.00 |
| 83014 |
|
40 |
40 |
$182.82 |
| 99177 |
|
135 |
135 |
$181.72 |
| 94664 |
|
13 |
12 |
$176.01 |
| 80061 |
Lipid panel |
17 |
17 |
$152.31 |
| 90686 |
|
3,383 |
3,380 |
$147.24 |
| G8484 |
Influenza immunization was not administered, reason not given |
3,071 |
2,756 |
$130.50 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
7,986 |
6,982 |
$126.15 |
| 1159F |
|
7,535 |
6,815 |
$115.00 |
| G9899 |
Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed |
2,482 |
2,238 |
$99.00 |
| 81025 |
|
13 |
12 |
$78.99 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
177 |
157 |
$66.00 |
| G8482 |
Influenza immunization administered or previously received |
4,739 |
4,358 |
$64.50 |
| 1000F |
|
17,209 |
15,500 |
$50.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
507 |
495 |
$40.50 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
27 |
27 |
$30.79 |
| 99000 |
|
17,917 |
16,860 |
$29.40 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
294 |
271 |
$25.00 |
| 3080F |
|
119 |
112 |
$17.00 |
| 99072 |
|
760 |
737 |
$15.00 |
| 87490 |
|
1,751 |
1,741 |
$8.14 |
| 3725F |
|
20,148 |
17,514 |
$6.00 |
| 77062 |
|
723 |
671 |
$2.22 |
| 3017F |
|
3,446 |
3,032 |
$2.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
14 |
14 |
$1.26 |
| G0104 |
Colorectal cancer screening; flexible sigmoidoscopy |
120 |
112 |
$0.31 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
3,053 |
2,758 |
$0.28 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
11,845 |
10,393 |
$0.00 |
| 1036F |
|
15,955 |
13,471 |
$0.00 |
| G9228 |
Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) |
411 |
396 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,304 |
2,081 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
607 |
578 |
$0.00 |
| G9227 |
Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter |
1,776 |
1,635 |
$0.00 |
| G8734 |
Elder maltreatment screen documented as negative, follow-up is not required |
596 |
508 |
$0.00 |
| 3008F |
|
1,035 |
866 |
$0.00 |
| G8542 |
Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required |
741 |
703 |
$0.00 |
| 3014F |
|
1,151 |
1,056 |
$0.00 |
| 90680 |
|
1,205 |
1,205 |
$0.00 |
| 3061F |
|
334 |
324 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
98 |
98 |
$0.00 |
| 90698 |
|
179 |
179 |
$0.00 |
| 3044F |
|
60 |
58 |
$0.00 |
| 3072F |
|
44 |
43 |
$0.00 |
| 90674 |
|
658 |
658 |
$0.00 |
| 97802 |
|
188 |
186 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
144 |
136 |
$0.00 |
| G8430 |
Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status) |
55 |
52 |
$0.00 |
| 99386 |
|
12 |
12 |
$0.00 |
| 3016F |
|
5,604 |
5,257 |
$0.00 |
| G9900 |
Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified |
69 |
67 |
$0.00 |
| 3085F |
|
3,344 |
3,332 |
$0.00 |
| G8399 |
Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed |
1,860 |
1,747 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
1,307 |
1,202 |
$0.00 |
| 4040F |
|
150 |
129 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
2,080 |
1,890 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
3,222 |
2,834 |
$0.00 |
| 96160 |
|
75 |
75 |
$0.00 |
| G8540 |
Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter |
453 |
428 |
$0.00 |
| G8541 |
Functional outcome assessment using a standardized tool not documented, reason not given |
32 |
31 |
$0.00 |
| 3210F |
|
672 |
662 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
872 |
825 |
$0.00 |
| 90713 |
|
99 |
99 |
$0.00 |
| 90685 |
|
196 |
195 |
$0.00 |
| 3288F |
|
260 |
216 |
$0.00 |
| 90715 |
|
210 |
210 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 2022F |
|
45 |
44 |
$0.00 |
| 1100F |
|
27 |
25 |
$0.00 |
| 4013F |
|
13 |
12 |
$0.00 |
| 4004F |
|
15 |
13 |
$0.00 |
| G8942 |
Functional outcome assessment using a standardized tool is documented within the previous 30 days and a care plan, based on identified deficiencies is documented within two days of the functional outcome assessment |
107 |
103 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
12 |
12 |
$0.00 |