| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
11,155 |
5,702 |
$962K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,673 |
4,442 |
$665K |
| 99205 |
Prolong outpt/office vis |
1,443 |
816 |
$155K |
| 76801 |
|
2,367 |
1,074 |
$129K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,343 |
1,545 |
$115K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,518 |
821 |
$75K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,160 |
572 |
$64K |
| 59410 |
|
73 |
67 |
$53K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
439 |
281 |
$46K |
| 99199 |
Unlisted special service, procedure or report |
7,265 |
4,151 |
$46K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
312 |
186 |
$25K |
| 81003 |
|
12,564 |
5,806 |
$21K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
117 |
99 |
$14K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
447 |
226 |
$12K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
12 |
$8K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
94 |
50 |
$7K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
61 |
26 |
$4K |
| 59430 |
|
52 |
26 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
89 |
24 |
$1K |
| 87210 |
|
307 |
183 |
$730.48 |
| 83986 |
|
314 |
180 |
$648.26 |
| 81025 |
|
272 |
126 |
$585.64 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
90 |
25 |
$274.99 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
14 |
$221.95 |
| 90688 |
|
28 |
14 |
$196.20 |
| 88141 |
|
62 |
45 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
15 |
12 |
$0.00 |