| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,556 |
12,390 |
$1.07M |
| 99215 |
Prolong outpt/office vis |
4,267 |
4,135 |
$465K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,220 |
2,076 |
$128K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,223 |
1,202 |
$115K |
| 99223 |
Prolong inpt eval add15 m |
802 |
746 |
$84K |
| 99233 |
Prolong inpt eval add15 m |
1,172 |
611 |
$62K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
583 |
570 |
$51K |
| 99497 |
|
748 |
741 |
$30K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,559 |
4,431 |
$29K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,465 |
3,145 |
$27K |
| 93000 |
|
3,178 |
3,135 |
$25K |
| 71046 |
Radiologic examination, chest; 2 views |
1,331 |
1,291 |
$21K |
| 80061 |
Lipid panel |
1,331 |
1,314 |
$14K |
| 90756 |
|
566 |
560 |
$13K |
| 82947 |
|
3,526 |
3,468 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,552 |
1,530 |
$11K |
| 83721 |
|
1,211 |
1,201 |
$9K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,682 |
1,571 |
$9K |
| 99406 |
|
1,077 |
1,042 |
$6K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
31 |
30 |
$6K |
| 82565 |
|
1,486 |
1,467 |
$6K |
| 94010 |
|
335 |
332 |
$5K |
| 96127 |
|
1,875 |
1,868 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
570 |
565 |
$5K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
693 |
652 |
$5K |
| 84520 |
|
1,486 |
1,468 |
$4K |
| 99442 |
|
134 |
131 |
$4K |
| 20610 |
|
182 |
136 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
26 |
$3K |
| 99441 |
|
193 |
183 |
$3K |
| 95923 |
|
31 |
31 |
$2K |
| 86769 |
|
55 |
55 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
962 |
863 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
504 |
471 |
$1K |
| G0310 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes) |
38 |
37 |
$931.00 |
| 86328 |
|
38 |
38 |
$900.30 |
| 96160 |
|
887 |
877 |
$806.75 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,119 |
1,053 |
$704.85 |
| 99401 |
|
67 |
67 |
$665.48 |
| 80305 |
|
140 |
131 |
$521.37 |
| 72110 |
|
15 |
13 |
$273.40 |
| 20553 |
|
12 |
12 |
$271.88 |
| 20552 |
|
15 |
15 |
$253.58 |
| 85651 |
|
145 |
139 |
$222.53 |
| 84443 |
Thyroid stimulating hormone (TSH) |
40 |
38 |
$201.03 |
| 99490 |
Ccm add 20min |
13 |
13 |
$183.16 |
| G0136 |
Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months |
17 |
17 |
$145.68 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
70 |
65 |
$106.91 |
| 81002 |
|
37 |
37 |
$81.06 |
| 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) |
13 |
12 |
$38.52 |
| 3074F |
|
3,422 |
3,174 |
$10.88 |
| 3078F |
|
2,473 |
2,317 |
$8.40 |
| 3079F |
|
1,981 |
1,877 |
$5.04 |
| 4013F |
|
532 |
507 |
$3.73 |
| 2014F |
|
1,242 |
1,231 |
$3.66 |
| 3075F |
|
872 |
837 |
$1.82 |
| 4010F |
|
986 |
942 |
$1.15 |
| 4037F |
|
365 |
363 |
$1.13 |
| 3066F |
|
815 |
787 |
$0.95 |
| 3051F |
|
69 |
58 |
$0.52 |
| 1159F |
|
71 |
71 |
$0.21 |
| 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) |
51 |
51 |
$0.18 |
| 3080F |
|
229 |
214 |
$0.16 |
| 3049F |
|
42 |
42 |
$0.13 |
| 4306F |
|
178 |
145 |
$0.11 |
| 3050F |
|
26 |
25 |
$0.11 |
| 3048F |
|
536 |
527 |
$0.10 |
| 3077F |
|
174 |
161 |
$0.07 |
| 1158F |
|
413 |
409 |
$0.05 |
| 3288F |
|
67 |
67 |
$0.01 |
| 1157F |
|
39 |
39 |
$0.01 |
| 1170F |
|
12 |
12 |
$0.01 |
| G9796 |
Patient is currently on a high intensity statin therapy |
205 |
200 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
267 |
266 |
$0.00 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
88 |
87 |
$0.00 |
| 81007 |
|
86 |
85 |
$0.00 |
| 99072 |
|
1,552 |
1,380 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
12 |
12 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
13 |
13 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
90 |
86 |
$0.00 |
| 3046F |
|
16 |
12 |
$0.00 |
| 3044F |
|
1,675 |
1,515 |
$0.00 |
| 94760 |
|
198 |
189 |
$0.00 |
| 3017F |
|
13 |
13 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
82 |
82 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
40 |
40 |
$0.00 |
| 1036F |
|
40 |
40 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
40 |
40 |
$0.00 |
| 3072F |
|
39 |
38 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
12 |
12 |
$0.00 |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
16 |
12 |
$0.00 |