| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1017 |
Targeted case management, each 15 minutes |
7,693 |
3,801 |
$180K |
| 99223 |
Prolong inpt eval add15 m |
1,359 |
1,016 |
$165K |
| 99233 |
Prolong inpt eval add15 m |
2,050 |
815 |
$116K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,435 |
1,291 |
$56K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,283 |
978 |
$46K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
986 |
401 |
$35K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
488 |
378 |
$32K |
| H1000 |
Prenatal care, at-risk assessment |
772 |
543 |
$27K |
| 99460 |
|
365 |
320 |
$23K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
393 |
328 |
$21K |
| 99222 |
Initial hospital care, per day, moderate complexity |
280 |
180 |
$17K |
| 99236 |
Prolong inpt eval add15 m |
202 |
135 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
266 |
239 |
$17K |
| T1024 |
Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter |
170 |
152 |
$17K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
636 |
469 |
$15K |
| 99215 |
Prolong outpt/office vis |
111 |
104 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
119 |
111 |
$11K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
78 |
77 |
$10K |
| 99235 |
|
70 |
66 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
60 |
60 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
89 |
84 |
$5K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
25 |
25 |
$4K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
24 |
24 |
$4K |
| 99243 |
|
72 |
49 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
40 |
39 |
$3K |
| 99462 |
|
166 |
118 |
$2K |
| 91300 |
|
110 |
108 |
$2K |
| 0002A |
|
47 |
47 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
43 |
37 |
$2K |
| 0012A |
|
49 |
49 |
$2K |
| 93325 |
|
121 |
111 |
$1K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
20 |
14 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
24 |
24 |
$734.58 |
| 94664 |
|
14 |
12 |
$533.87 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
171 |
163 |
$416.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
28 |
$359.64 |
| 92567 |
|
245 |
188 |
$321.35 |
| 92060 |
|
61 |
57 |
$295.25 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
27 |
27 |
$199.23 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
25 |
24 |
$139.17 |
| 3008F |
|
83 |
67 |
$124.12 |
| 92587 |
|
36 |
26 |
$85.23 |
| 76820 |
|
142 |
74 |
$73.34 |
| 93000 |
|
77 |
74 |
$69.93 |
| 92015 |
Determination of refractive state |
270 |
240 |
$68.15 |
| 0001A |
|
33 |
33 |
$46.00 |
| 1159F |
|
133 |
115 |
$0.00 |
| 1160F |
|
245 |
222 |
$0.00 |
| 90670 |
|
39 |
39 |
$0.00 |
| 3078F |
|
13 |
13 |
$0.00 |
| 73630 |
|
13 |
12 |
$0.00 |
| 1036F |
|
60 |
57 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
45 |
41 |
$0.00 |
| 91301 |
|
83 |
82 |
$0.00 |
| 3074F |
|
14 |
14 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 99024 |
|
74 |
65 |
$0.00 |
| 93320 |
|
24 |
24 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |