| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
4,889 |
4,880 |
$124K |
| 01992 |
|
569 |
568 |
$49K |
| 01961 |
|
2,040 |
2,035 |
$40K |
| 00790 |
|
1,237 |
1,177 |
$11K |
| 00731 |
|
2,181 |
2,130 |
$10K |
| 00142 |
|
420 |
387 |
$8K |
| 00813 |
|
460 |
459 |
$8K |
| 00797 |
|
469 |
469 |
$5K |
| 01940 |
|
38 |
38 |
$3K |
| 01480 |
|
317 |
305 |
$3K |
| 00840 |
|
563 |
560 |
$3K |
| 00400 |
|
524 |
463 |
$1K |
| 00811 |
|
304 |
303 |
$1K |
| 00732 |
|
132 |
121 |
$1K |
| 36620 |
|
539 |
508 |
$741.97 |
| 36556 |
|
189 |
175 |
$607.60 |
| 00140 |
|
25 |
25 |
$317.93 |
| 01844 |
|
42 |
42 |
$83.51 |
| 00300 |
|
15 |
15 |
$66.02 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,106 |
1,030 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
503 |
496 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
424 |
365 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
19 |
19 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
911 |
858 |
$0.00 |
| 83021 |
|
29 |
29 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
308 |
292 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
54 |
54 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
310 |
139 |
$0.00 |
| 83789 |
|
29 |
29 |
$0.00 |
| 01996 |
|
417 |
402 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16 |
15 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
412 |
397 |
$0.00 |
| 81001 |
|
422 |
390 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
150 |
149 |
$0.00 |
| 82607 |
|
64 |
61 |
$0.00 |
| 90744 |
|
79 |
65 |
$0.00 |
| 82746 |
|
12 |
12 |
$0.00 |
| 83690 |
|
90 |
77 |
$0.00 |
| 86850 |
|
91 |
86 |
$0.00 |
| 84703 |
|
15 |
13 |
$0.00 |
| 99381 |
|
47 |
47 |
$0.00 |
| 93000 |
|
109 |
109 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
261 |
252 |
$0.00 |
| 96151 |
|
12 |
12 |
$0.00 |
| 87088 |
|
130 |
124 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,100 |
673 |
$0.00 |
| 82261 |
|
29 |
29 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
540 |
425 |
$0.00 |
| 87510 |
|
39 |
39 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
77 |
77 |
$0.00 |
| 82728 |
|
48 |
47 |
$0.00 |
| 86361 |
|
53 |
53 |
$0.00 |
| 82950 |
|
34 |
32 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
106 |
96 |
$0.00 |
| 85652 |
|
13 |
13 |
$0.00 |
| 86901 |
|
107 |
99 |
$0.00 |
| A7016 |
Dome and mouthpiece, used with small volume ultrasonic nebulizer |
84 |
74 |
$0.00 |
| 86592 |
|
98 |
91 |
$0.00 |
| 80050 |
General health panel |
84 |
84 |
$0.00 |
| 84484 |
|
96 |
60 |
$0.00 |
| 87205 |
|
18 |
14 |
$0.00 |
| 90686 |
|
71 |
71 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
133 |
133 |
$0.00 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
27 |
27 |
$0.00 |
| 85018 |
|
226 |
223 |
$0.00 |
| 92551 |
|
86 |
86 |
$0.00 |
| 85027 |
|
258 |
215 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
84 |
74 |
$0.00 |
| 82962 |
|
113 |
102 |
$0.00 |
| 87040 |
|
59 |
49 |
$0.00 |
| 83605 |
|
45 |
33 |
$0.00 |
| 82043 |
|
40 |
39 |
$0.00 |
| 86780 |
|
170 |
164 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
21 |
19 |
$0.00 |
| 85730 |
|
30 |
23 |
$0.00 |
| 85013 |
|
14 |
14 |
$0.00 |
| 86593 |
|
27 |
27 |
$0.00 |
| 80047 |
|
266 |
220 |
$0.00 |
| 82803 |
|
27 |
16 |
$0.00 |
| 83498 |
|
29 |
29 |
$0.00 |
| 85651 |
|
31 |
30 |
$0.00 |
| 87503 |
|
57 |
57 |
$0.00 |
| 94760 |
|
25 |
22 |
$0.00 |
| 94010 |
|
12 |
12 |
$0.00 |
| 90680 |
|
37 |
36 |
$0.00 |
| 36416 |
|
13 |
13 |
$0.00 |
| 83615 |
|
43 |
25 |
$0.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
36 |
34 |
$0.00 |
| 88142 |
|
13 |
13 |
$0.00 |
| 90698 |
|
89 |
65 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
48 |
48 |
$0.00 |
| 86695 |
|
14 |
14 |
$0.00 |
| 86140 |
|
41 |
32 |
$0.00 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
35 |
35 |
$0.00 |
| 83880 |
|
48 |
35 |
$0.00 |
| 87480 |
|
39 |
39 |
$0.00 |
| 83735 |
|
208 |
60 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
14 |
14 |
$0.00 |
| 80081 |
|
29 |
29 |
$0.00 |
| 87511 |
|
16 |
16 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$0.00 |
| 01968 |
|
286 |
283 |
$0.00 |
| 90700 |
|
76 |
75 |
$0.00 |
| 59425 |
|
441 |
308 |
$0.00 |
| 99401 |
|
12 |
12 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
286 |
231 |
$0.00 |
| 81002 |
|
479 |
385 |
$0.00 |
| 87653 |
|
30 |
30 |
$0.00 |
| 01965 |
|
40 |
38 |
$0.00 |
| 86480 |
|
29 |
29 |
$0.00 |
| 00851 |
|
271 |
271 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
73 |
72 |
$0.00 |
| 83540 |
|
54 |
53 |
$0.00 |
| 84439 |
|
26 |
26 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
106 |
106 |
$0.00 |
| 84156 |
|
38 |
30 |
$0.00 |
| 82565 |
|
38 |
27 |
$0.00 |
| 85610 |
|
221 |
133 |
$0.00 |
| 80061 |
Lipid panel |
447 |
441 |
$0.00 |
| 83655 |
|
15 |
15 |
$0.00 |
| 00940 |
|
114 |
114 |
$0.00 |
| 81025 |
|
95 |
89 |
$0.00 |
| 87186 |
|
13 |
13 |
$0.00 |
| 87420 |
|
13 |
13 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
157 |
157 |
$0.00 |
| 90461 |
|
64 |
63 |
$0.00 |
| 84100 |
|
140 |
52 |
$0.00 |
| 84702 |
|
65 |
63 |
$0.00 |
| 84550 |
|
136 |
125 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
84 |
74 |
$0.00 |
| 90670 |
|
157 |
130 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
120 |
93 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
224 |
222 |
$0.00 |
| 80076 |
|
159 |
128 |
$0.00 |
| 82274 |
|
31 |
30 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
90 |
86 |
$0.00 |
| 90648 |
|
49 |
48 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
157 |
156 |
$0.00 |
| 82947 |
|
183 |
179 |
$0.00 |
| 99173 |
|
90 |
90 |
$0.00 |
| 90685 |
|
77 |
63 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
124 |
106 |
$0.00 |
| 87660 |
|
39 |
39 |
$0.00 |
| 99382 |
|
12 |
12 |
$0.00 |
| 90633 |
|
49 |
49 |
$0.00 |
| 82776 |
|
29 |
29 |
$0.00 |
| 86900 |
|
107 |
99 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
57 |
57 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
261 |
252 |
$0.00 |
| 84466 |
|
39 |
38 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
15 |
14 |
$0.00 |
| 90713 |
|
44 |
43 |
$0.00 |
| 83516 |
|
30 |
30 |
$0.00 |
| 87210 |
|
58 |
49 |
$0.00 |
| 86696 |
|
36 |
36 |
$0.00 |
| 90681 |
|
14 |
14 |
$0.00 |
| 87481 |
|
19 |
17 |
$0.00 |
| 82248 |
|
64 |
62 |
$0.00 |
| 93880 |
|
13 |
13 |
$0.00 |
| 82570 |
|
65 |
58 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$0.00 |
| 82247 |
|
51 |
28 |
$0.00 |
| 01470 |
|
23 |
15 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
51 |
48 |
$0.00 |
| 80074 |
|
14 |
13 |
$0.00 |
| 92552 |
|
45 |
45 |
$0.00 |
| 87641 |
|
16 |
15 |
$0.00 |
| 00670 |
|
14 |
13 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
20 |
17 |
$0.00 |
| T4541 |
Incontinence product, disposable underpad, large, each |
12 |
12 |
$0.00 |