| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,934 |
6,064 |
$270K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,844 |
3,158 |
$172K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
889 |
687 |
$72K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,735 |
2,833 |
$66K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,258 |
1,173 |
$63K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
844 |
523 |
$49K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,079 |
991 |
$47K |
| 59430 |
|
502 |
442 |
$41K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
898 |
767 |
$33K |
| 99215 |
Prolong outpt/office vis |
504 |
415 |
$32K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
234 |
218 |
$30K |
| 76820 |
|
780 |
486 |
$26K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
45 |
42 |
$23K |
| 92587 |
|
1,555 |
1,395 |
$20K |
| 76801 |
|
227 |
196 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
380 |
339 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,284 |
1,903 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,222 |
532 |
$15K |
| 81002 |
|
5,809 |
3,337 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,175 |
1,021 |
$14K |
| 99000 |
|
1,538 |
1,255 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
515 |
440 |
$12K |
| 92567 |
|
1,250 |
1,073 |
$12K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
178 |
167 |
$9K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
148 |
122 |
$9K |
| 69210 |
|
245 |
213 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
75 |
63 |
$6K |
| 90461 |
|
1,833 |
1,480 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
56 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
87 |
78 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
60 |
44 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
98 |
85 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
118 |
114 |
$2K |
| 81025 |
|
211 |
176 |
$962.04 |
| 99460 |
|
12 |
12 |
$620.97 |
| 90480 |
|
13 |
13 |
$390.00 |
| 96127 |
|
480 |
342 |
$264.60 |
| 90670 |
|
744 |
676 |
$155.40 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
20 |
16 |
$122.73 |
| 90686 |
|
1,593 |
1,396 |
$89.16 |
| 90680 |
|
606 |
562 |
$72.80 |
| 82950 |
|
13 |
12 |
$31.92 |
| 90700 |
|
356 |
321 |
$22.75 |
| 99173 |
|
1,188 |
1,058 |
$22.05 |
| 96161 |
|
387 |
377 |
$5.75 |
| 99072 |
|
182 |
149 |
$0.00 |
| 90707 |
|
116 |
104 |
$0.00 |
| 1159F |
|
459 |
280 |
$0.00 |
| 90713 |
|
187 |
167 |
$0.00 |
| 3725F |
|
271 |
177 |
$0.00 |
| 3078F |
|
459 |
284 |
$0.00 |
| 90633 |
|
120 |
115 |
$0.00 |
| 90648 |
|
185 |
167 |
$0.00 |
| 1160F |
|
454 |
279 |
$0.00 |
| 0502F |
|
63 |
35 |
$0.00 |
| 3074F |
|
441 |
273 |
$0.00 |
| 90744 |
|
39 |
36 |
$0.00 |
| 90677 |
|
261 |
258 |
$0.00 |
| 1036F |
|
393 |
234 |
$0.00 |
| 90716 |
|
125 |
108 |
$0.00 |
| 3008F |
|
524 |
318 |
$0.00 |
| 90697 |
|
487 |
469 |
$0.00 |
| 36416 |
|
134 |
91 |
$0.00 |
| 90656 |
|
218 |
218 |
$0.00 |
| 1126F |
|
251 |
157 |
$0.00 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
14 |
12 |
$0.00 |