| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,788 |
7,528 |
$301K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,765 |
6,561 |
$274K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
801 |
800 |
$56K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
382 |
274 |
$23K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
352 |
202 |
$17K |
| 0002A |
|
317 |
317 |
$10K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
209 |
208 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
504 |
502 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
244 |
193 |
$8K |
| 0001A |
|
250 |
249 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
759 |
710 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
277 |
274 |
$7K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
809 |
753 |
$6K |
| 0011A |
|
131 |
123 |
$5K |
| 90834 |
Psychotherapy, 45 minutes with patient |
44 |
25 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
78 |
78 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
183 |
183 |
$3K |
| 17110 |
|
30 |
28 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
32 |
$2K |
| 76830 |
Ultrasound, transvaginal |
69 |
68 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
52 |
52 |
$1K |
| 90686 |
|
118 |
117 |
$1K |
| 91322 |
|
12 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$969.46 |
| 52000 |
|
13 |
13 |
$797.28 |
| 0012A |
|
29 |
28 |
$758.52 |
| 90480 |
|
20 |
20 |
$736.08 |
| 90674 |
|
35 |
35 |
$564.21 |
| 90661 |
|
85 |
84 |
$494.55 |
| 96127 |
|
1,032 |
1,024 |
$471.88 |
| 51798 |
|
95 |
95 |
$341.92 |
| 0004A |
|
14 |
14 |
$325.73 |
| 90677 |
|
43 |
43 |
$266.70 |
| 90688 |
|
12 |
12 |
$185.23 |
| 81002 |
|
128 |
127 |
$147.78 |
| G0008 |
Administration of influenza virus vaccine |
29 |
29 |
$32.11 |
| 91301 |
|
122 |
110 |
$0.01 |
| 3008F |
|
115 |
110 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 91300 |
|
28 |
27 |
$0.00 |