| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Z1034 |
|
8,497 |
6,697 |
$510K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,232 |
25,217 |
$384K |
| 59425 |
|
7,059 |
5,289 |
$303K |
| Z1032 |
|
1,555 |
1,555 |
$249K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,316 |
4,217 |
$226K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,949 |
11,229 |
$210K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
424 |
421 |
$188K |
| 99381 |
|
1,283 |
1,261 |
$125K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12,970 |
12,857 |
$107K |
| 90697 |
|
1,246 |
1,232 |
$74K |
| 99215 |
Prolong outpt/office vis |
984 |
903 |
$68K |
| G9920 |
Screening performed and negative |
7,967 |
7,873 |
$35K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
248 |
223 |
$30K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
351 |
347 |
$29K |
| 81025 |
|
6,721 |
6,222 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,460 |
3,407 |
$23K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
352 |
276 |
$21K |
| 90680 |
|
2,440 |
2,425 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,737 |
1,719 |
$13K |
| 90670 |
|
2,849 |
2,837 |
$13K |
| 90651 |
|
494 |
482 |
$12K |
| 92551 |
|
6,858 |
6,809 |
$11K |
| 90648 |
|
2,383 |
2,360 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,300 |
1,285 |
$10K |
| J3490 |
Unclassified drugs |
96 |
81 |
$10K |
| 90723 |
|
1,685 |
1,681 |
$9K |
| 99383 |
|
115 |
105 |
$7K |
| Z6410 |
|
415 |
361 |
$7K |
| 99000 |
|
2,676 |
2,567 |
$7K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
409 |
328 |
$6K |
| 81003 |
|
8,703 |
8,069 |
$4K |
| Z6500 |
|
33 |
33 |
$4K |
| 99460 |
|
113 |
113 |
$4K |
| 99384 |
|
42 |
31 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,439 |
7,313 |
$3K |
| 90677 |
|
698 |
687 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
80 |
80 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
80 |
80 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
896 |
871 |
$2K |
| 85018 |
|
9,940 |
9,744 |
$2K |
| 90633 |
|
1,289 |
1,274 |
$2K |
| 0011A |
|
109 |
77 |
$2K |
| 90686 |
|
1,711 |
1,702 |
$2K |
| 0012A |
|
105 |
77 |
$2K |
| 90674 |
|
92 |
85 |
$1K |
| 59430 |
|
26 |
26 |
$1K |
| 90658 |
|
163 |
156 |
$1K |
| 93000 |
|
1,499 |
1,486 |
$995.22 |
| 90671 |
|
227 |
225 |
$900.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,412 |
1,391 |
$848.33 |
| 90744 |
|
146 |
145 |
$837.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
589 |
553 |
$777.24 |
| 90716 |
|
354 |
349 |
$747.00 |
| Z6304 |
|
48 |
48 |
$732.76 |
| Z6204 |
|
48 |
48 |
$732.76 |
| Z6406 |
|
48 |
48 |
$732.76 |
| 99462 |
|
28 |
26 |
$670.40 |
| 90734 |
|
365 |
362 |
$650.25 |
| Z6400 |
|
75 |
75 |
$642.71 |
| 90700 |
|
434 |
433 |
$569.25 |
| 99401 |
|
7,679 |
7,602 |
$445.75 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
7,526 |
7,346 |
$435.70 |
| 97803 |
|
31 |
30 |
$432.90 |
| 96151 |
|
32 |
31 |
$432.90 |
| 90710 |
|
254 |
254 |
$420.75 |
| 90707 |
|
313 |
308 |
$405.00 |
| 90714 |
|
94 |
93 |
$297.00 |
| 90715 |
|
89 |
89 |
$252.00 |
| 90696 |
|
114 |
114 |
$144.00 |
| 90656 |
|
102 |
100 |
$135.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,500 |
4,415 |
$100.87 |
| 90620 |
|
70 |
70 |
$99.00 |
| 90713 |
|
23 |
23 |
$81.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
66 |
$27.05 |
| 82947 |
|
65 |
62 |
$23.76 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
96 |
87 |
$21.22 |
| 90621 |
|
15 |
15 |
$9.00 |
| 3078F |
|
8,986 |
8,530 |
$0.00 |
| 0502F |
|
6,267 |
4,685 |
$0.00 |
| 3725F |
|
2,337 |
2,332 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,485 |
1,471 |
$0.00 |
| 99173 |
|
5,764 |
5,716 |
$0.00 |
| 3077F |
|
1,466 |
1,420 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
187 |
184 |
$0.00 |
| 90473 |
|
152 |
135 |
$0.00 |
| 99499 |
|
128 |
127 |
$0.00 |
| 3074F |
|
7,261 |
6,917 |
$0.00 |
| 3044F |
|
790 |
764 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
5,366 |
5,230 |
$0.00 |
| 3079F |
|
586 |
577 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
3,498 |
3,435 |
$0.00 |
| 3075F |
|
998 |
974 |
$0.00 |
| 90474 |
|
395 |
389 |
$0.00 |
| 91301 |
|
191 |
183 |
$0.00 |
| 3080F |
|
479 |
464 |
$0.00 |
| 99385 |
|
59 |
52 |
$0.00 |
| 0500F |
|
40 |
38 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
58 |
51 |
$0.00 |