| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,074 |
4,417 |
$365K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,776 |
1,735 |
$182K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
160 |
160 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
193 |
179 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
30 |
30 |
$3K |
| 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) |
60 |
60 |
$769.87 |
| 36415 |
Collection of venous blood by venipuncture |
252 |
250 |
$525.00 |
| 4013F |
|
465 |
464 |
$0.00 |
| 1159F |
|
28 |
28 |
$0.00 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
35 |
35 |
$0.00 |
| 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) |
405 |
405 |
$0.00 |
| 1160F |
|
228 |
228 |
$0.00 |
| 3078F |
|
186 |
178 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
125 |
121 |
$0.00 |
| 3725F |
|
30 |
30 |
$0.00 |
| 3342F |
|
13 |
13 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
686 |
605 |
$0.00 |
| 3074F |
|
236 |
223 |
$0.00 |
| 3008F |
|
3,908 |
3,355 |
$0.00 |
| 3061F |
|
44 |
44 |
$0.00 |
| 4010F |
|
135 |
135 |
$0.00 |
| 3048F |
|
241 |
240 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
28 |
28 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17 |
17 |
$0.00 |
| 3341F |
|
15 |
14 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |