| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,313 |
873 |
$197K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
550 |
382 |
$46K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,186 |
1,902 |
$33K |
| 59425 |
|
2,171 |
1,468 |
$32K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,883 |
1,284 |
$16K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
493 |
493 |
$14K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
493 |
493 |
$14K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
882 |
878 |
$11K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
292 |
292 |
$5K |
| Z1032 |
|
31 |
31 |
$5K |
| Z6500 |
|
31 |
31 |
$4K |
| 99000 |
|
2,146 |
2,076 |
$3K |
| 86780 |
|
292 |
292 |
$3K |
| Z1034 |
|
16 |
16 |
$892.68 |
| 99215 |
Prolong outpt/office vis |
83 |
83 |
$757.86 |
| H2000 |
Comprehensive multidisciplinary evaluation |
167 |
167 |
$600.00 |
| Z6400 |
|
39 |
36 |
$548.04 |
| 3080F |
|
80 |
80 |
$108.00 |
| 81025 |
|
175 |
175 |
$89.08 |
| 90686 |
|
12 |
12 |
$63.00 |
| 90670 |
|
118 |
116 |
$63.00 |
| 90633 |
|
30 |
29 |
$54.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$25.83 |
| 81000 |
|
1,207 |
1,022 |
$20.46 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
414 |
406 |
$4.46 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
291 |
287 |
$0.00 |
| 3079F |
|
41 |
38 |
$0.00 |
| 92551 |
|
131 |
131 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
33 |
33 |
$0.00 |
| 3008F |
|
49 |
49 |
$0.00 |
| 1220F |
|
62 |
61 |
$0.00 |
| 96156 |
|
33 |
31 |
$0.00 |
| 96151 |
|
47 |
45 |
$0.00 |
| 3074F |
|
16 |
16 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 99173 |
|
139 |
139 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
47 |
46 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
206 |
202 |
$0.00 |
| 3078F |
|
146 |
145 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
176 |
175 |
$0.00 |
| 97803 |
|
73 |
71 |
$0.00 |
| 3077F |
|
13 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
39 |
$0.00 |
| 99401 |
|
68 |
67 |
$0.00 |
| 92552 |
|
50 |
50 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
49 |
49 |
$0.00 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
12 |
12 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
12 |
12 |
$0.00 |