| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
8,485 |
6,102 |
$960K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,770 |
1,289 |
$150K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,566 |
1,379 |
$96K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
298 |
268 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
458 |
332 |
$28K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
368 |
277 |
$27K |
| 99205 |
Prolong outpt/office vis |
174 |
164 |
$26K |
| 76801 |
|
218 |
194 |
$20K |
| 99199 |
Unlisted special service, procedure or report |
5,639 |
5,466 |
$20K |
| 81002 |
|
6,881 |
4,852 |
$17K |
| 99236 |
Prolong inpt eval add15 m |
106 |
80 |
$16K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
165 |
146 |
$15K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
339 |
310 |
$15K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
120 |
98 |
$13K |
| 81025 |
|
1,521 |
1,310 |
$10K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
125 |
107 |
$9K |
| 87210 |
|
1,781 |
837 |
$7K |
| 90674 |
|
165 |
151 |
$3K |
| 80305 |
|
253 |
229 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
89 |
77 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
129 |
119 |
$1K |