| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
659 |
419 |
$97K |
| Z1034 |
|
1,560 |
1,201 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,905 |
2,542 |
$64K |
| Z1032 |
|
309 |
309 |
$46K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
451 |
278 |
$36K |
| Z6500 |
|
251 |
251 |
$31K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
599 |
598 |
$27K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
302 |
175 |
$18K |
| 99383 |
|
104 |
104 |
$13K |
| 92552 |
|
468 |
468 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
29 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
81 |
80 |
$9K |
| Z6400 |
|
578 |
547 |
$9K |
| 99381 |
|
77 |
77 |
$8K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
529 |
517 |
$7K |
| Z6406 |
|
593 |
533 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
60 |
60 |
$5K |
| 99000 |
|
1,804 |
1,734 |
$5K |
| Z6204 |
|
595 |
539 |
$5K |
| 92015 |
Determination of refractive state |
419 |
419 |
$3K |
| 76813 |
|
31 |
26 |
$3K |
| Z6410 |
|
194 |
157 |
$3K |
| 99384 |
|
13 |
13 |
$2K |
| 90633 |
|
181 |
180 |
$2K |
| 96156 |
|
154 |
125 |
$2K |
| 99382 |
|
12 |
12 |
$2K |
| 97803 |
|
146 |
105 |
$1K |
| 90744 |
|
163 |
161 |
$1K |
| Z6304 |
|
162 |
153 |
$1K |
| 99401 |
|
119 |
86 |
$1K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
62 |
52 |
$932.46 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
814 |
754 |
$886.52 |
| 81025 |
|
317 |
317 |
$822.71 |
| 90670 |
|
86 |
84 |
$774.00 |
| 81000 |
|
419 |
306 |
$717.06 |
| 92551 |
|
266 |
265 |
$612.94 |
| 90680 |
|
52 |
52 |
$468.00 |
| 99201 |
|
14 |
14 |
$432.66 |
| 90698 |
|
32 |
32 |
$288.00 |
| 90713 |
|
26 |
26 |
$234.00 |
| 90707 |
|
19 |
19 |
$171.00 |
| 90700 |
|
14 |
14 |
$126.00 |
| 90716 |
|
13 |
13 |
$117.00 |
| 99173 |
|
221 |
220 |
$4.79 |
| 1126F |
|
1,581 |
1,394 |
$0.00 |
| 3074F |
|
1,001 |
889 |
$0.00 |
| 3008F |
|
441 |
370 |
$0.00 |
| 3080F |
|
158 |
148 |
$0.00 |
| 3079F |
|
63 |
58 |
$0.00 |
| 1220F |
|
41 |
41 |
$0.00 |
| 85018 |
|
17 |
17 |
$0.00 |
| 1125F |
|
18 |
18 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 1160F |
|
735 |
686 |
$0.00 |
| 3078F |
|
1,526 |
1,360 |
$0.00 |
| 1159F |
|
1,083 |
1,004 |
$0.00 |
| 3077F |
|
293 |
264 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$0.00 |