| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
4,829 |
2,151 |
$349K |
| 59410 |
|
616 |
522 |
$344K |
| 59515 |
|
378 |
300 |
$239K |
| 59425 |
|
3,219 |
2,088 |
$222K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,674 |
3,944 |
$185K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
196 |
148 |
$103K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,991 |
1,369 |
$91K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,644 |
1,219 |
$83K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,926 |
1,332 |
$75K |
| 99223 |
Prolong inpt eval add15 m |
333 |
254 |
$41K |
| 59025 |
Fetal non-stress test |
2,420 |
1,287 |
$41K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
936 |
532 |
$39K |
| 76830 |
Ultrasound, transvaginal |
623 |
454 |
$28K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,795 |
1,539 |
$25K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,800 |
1,541 |
$25K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
645 |
457 |
$24K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
592 |
424 |
$23K |
| 59514 |
|
234 |
164 |
$23K |
| 99215 |
Prolong outpt/office vis |
382 |
268 |
$21K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
798 |
475 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
391 |
295 |
$18K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
19 |
16 |
$18K |
| 76801 |
|
1,104 |
555 |
$16K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
712 |
462 |
$16K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
561 |
350 |
$14K |
| 99236 |
Prolong inpt eval add15 m |
197 |
90 |
$13K |
| 59020 |
|
556 |
371 |
$11K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
38 |
24 |
$11K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
195 |
169 |
$11K |
| 81025 |
|
2,523 |
1,782 |
$9K |
| 11981 |
|
174 |
140 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
176 |
137 |
$8K |
| 99222 |
Initial hospital care, per day, moderate complexity |
104 |
90 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
112 |
91 |
$7K |
| 59430 |
|
158 |
144 |
$6K |
| 87660 |
|
616 |
438 |
$5K |
| 87480 |
|
620 |
441 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,427 |
1,032 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
275 |
205 |
$5K |
| 87510 |
|
582 |
409 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
698 |
550 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
1,954 |
1,290 |
$4K |
| 90678 |
|
18 |
17 |
$3K |
| 58300 |
|
38 |
35 |
$3K |
| 99205 |
Prolong outpt/office vis |
30 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
253 |
194 |
$2K |
| 90715 |
|
137 |
115 |
$2K |
| 81003 |
|
2,041 |
1,332 |
$2K |
| 99459 |
|
1,014 |
631 |
$2K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
245 |
149 |
$2K |
| 76818 |
|
59 |
22 |
$2K |
| 80061 |
Lipid panel |
366 |
251 |
$1K |
| 80305 |
|
403 |
247 |
$1K |
| 58611 |
|
30 |
16 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
146 |
111 |
$1K |
| 82950 |
|
521 |
407 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
16 |
13 |
$804.05 |
| 81002 |
|
617 |
442 |
$752.43 |
| 82947 |
|
568 |
362 |
$685.86 |
| 81015 |
|
571 |
400 |
$650.35 |
| 81001 |
|
491 |
355 |
$640.31 |
| 99385 |
|
49 |
24 |
$635.04 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
16 |
$614.26 |
| 11982 |
|
20 |
13 |
$605.25 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
164 |
117 |
$484.88 |
| 90661 |
|
67 |
39 |
$341.03 |
| 85660 |
|
283 |
161 |
$312.98 |
| 87210 |
|
153 |
104 |
$279.72 |
| 84443 |
Thyroid stimulating hormone (TSH) |
64 |
44 |
$271.50 |
| 86901 |
|
291 |
180 |
$246.81 |
| 86900 |
|
304 |
185 |
$244.12 |
| 90656 |
|
19 |
16 |
$183.92 |
| 96127 |
|
60 |
55 |
$167.52 |
| 96160 |
|
115 |
106 |
$76.26 |
| 80081 |
|
59 |
27 |
$67.37 |
| 81000 |
|
43 |
29 |
$61.54 |
| 87081 |
|
13 |
12 |
$30.26 |
| 86592 |
|
32 |
28 |
$11.78 |
| 0503F |
|
73 |
71 |
$0.00 |
| 3008F |
|
123 |
73 |
$0.00 |
| 36416 |
|
195 |
142 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
14 |
13 |
$0.00 |
| 0501F |
|
22 |
18 |
$0.00 |
| 86787 |
|
18 |
12 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
40 |
32 |
$0.00 |