| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Z1034 |
|
6,981 |
4,860 |
$381K |
| Z1032 |
|
1,061 |
1,061 |
$168K |
| Z6500 |
|
1,107 |
1,107 |
$136K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
222 |
222 |
$92K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,829 |
1,783 |
$82K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,592 |
2,584 |
$71K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,146 |
2,127 |
$62K |
| Z6412 |
|
3,142 |
1,004 |
$55K |
| 99381 |
|
461 |
422 |
$37K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
971 |
963 |
$36K |
| Z6410 |
|
1,607 |
1,575 |
$34K |
| 97802 |
|
3,088 |
3,049 |
$34K |
| 99201 |
|
626 |
415 |
$34K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
456 |
456 |
$34K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,152 |
6,687 |
$25K |
| Z6400 |
|
1,842 |
1,805 |
$24K |
| Z1038 |
|
426 |
426 |
$23K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
480 |
480 |
$21K |
| 90715 |
|
848 |
680 |
$20K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
548 |
548 |
$19K |
| 76801 |
|
288 |
287 |
$18K |
| Z6406 |
|
826 |
805 |
$13K |
| 90686 |
|
1,288 |
1,287 |
$12K |
| 90670 |
|
1,450 |
1,448 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,357 |
3,185 |
$10K |
| 90647 |
|
1,127 |
1,125 |
$8K |
| Z6414 |
|
613 |
499 |
$8K |
| Z6304 |
|
833 |
829 |
$8K |
| 59514 |
|
17 |
17 |
$7K |
| 90680 |
|
860 |
857 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
147 |
147 |
$7K |
| 90685 |
|
912 |
912 |
$7K |
| 90688 |
|
1,337 |
1,334 |
$7K |
| 92551 |
|
1,437 |
1,435 |
$6K |
| 90700 |
|
959 |
958 |
$6K |
| 90633 |
|
871 |
870 |
$6K |
| Z6204 |
|
757 |
747 |
$6K |
| 90713 |
|
827 |
826 |
$6K |
| Z6208 |
|
436 |
436 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
169 |
169 |
$5K |
| 90744 |
|
603 |
602 |
$4K |
| 90710 |
|
569 |
569 |
$4K |
| 83655 |
|
466 |
466 |
$4K |
| 90734 |
|
530 |
530 |
$3K |
| Z6308 |
|
434 |
434 |
$3K |
| 90723 |
|
354 |
354 |
$3K |
| 99384 |
|
34 |
31 |
$3K |
| Z6408 |
|
260 |
260 |
$3K |
| 80061 |
Lipid panel |
440 |
440 |
$2K |
| 90716 |
|
337 |
337 |
$2K |
| Z6206 |
|
223 |
223 |
$2K |
| 85018 |
|
1,768 |
1,763 |
$2K |
| 90649 |
|
361 |
360 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
534 |
523 |
$2K |
| 99383 |
|
39 |
39 |
$2K |
| 96156 |
|
172 |
172 |
$2K |
| S0197 |
Prenatal vitamins, 30-day supply |
1,134 |
634 |
$2K |
| 99000 |
|
855 |
842 |
$2K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
800 |
374 |
$967.10 |
| 59425 |
|
613 |
414 |
$958.08 |
| 90696 |
|
165 |
164 |
$931.50 |
| 90651 |
|
81 |
81 |
$729.00 |
| 90620 |
|
122 |
122 |
$684.00 |
| 90707 |
|
58 |
57 |
$463.50 |
| 93000 |
|
40 |
40 |
$409.60 |
| 86580 |
|
224 |
224 |
$376.33 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,224 |
1,218 |
$161.60 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
288 |
287 |
$66.12 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
86 |
85 |
$45.26 |
| 92081 |
|
1,046 |
1,044 |
$44.15 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
118 |
118 |
$27.00 |
| 96127 |
|
63 |
63 |
$23.80 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
34 |
33 |
$18.75 |
| 90674 |
|
26 |
26 |
$18.00 |
| 82947 |
|
432 |
381 |
$16.35 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
66 |
66 |
$0.02 |
| 1160F |
|
589 |
529 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
28 |
28 |
$0.00 |
| 4120F |
|
301 |
294 |
$0.00 |
| 3077F |
|
78 |
73 |
$0.00 |
| 1124F |
|
28 |
28 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
630 |
579 |
$0.00 |
| 99401 |
|
374 |
371 |
$0.00 |
| 1033F |
|
251 |
248 |
$0.00 |
| 3078F |
|
274 |
255 |
$0.00 |
| 1159F |
|
533 |
477 |
$0.00 |
| 99497 |
|
41 |
41 |
$0.00 |
| 0521F |
|
120 |
115 |
$0.00 |
| 1158F |
|
27 |
27 |
$0.00 |
| 3288F |
|
13 |
13 |
$0.00 |
| 90461 |
|
161 |
161 |
$0.00 |
| 3725F |
|
96 |
96 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17 |
17 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
28 |
28 |
$0.00 |
| 83037 |
|
14 |
14 |
$0.00 |
| 99080 |
|
13 |
13 |
$0.00 |
| 0502F |
|
26 |
24 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
13 |
12 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
13 |
$0.00 |
| 3008F |
|
4,505 |
4,299 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
2,829 |
2,598 |
$0.00 |
| 1036F |
|
2,825 |
2,604 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
215 |
215 |
$0.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
180 |
123 |
$0.00 |
| 3079F |
|
13 |
13 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
302 |
301 |
$0.00 |
| 1126F |
|
171 |
165 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
47 |
47 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
75 |
71 |
$0.00 |
| 1000F |
|
428 |
399 |
$0.00 |
| 1170F |
|
431 |
380 |
$0.00 |
| G8708 |
Patient not prescribed antibiotic |
13 |
13 |
$0.00 |
| 4010F |
|
12 |
12 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
63 |
62 |
$0.00 |
| 36416 |
|
437 |
386 |
$0.00 |
| 1125F |
|
381 |
347 |
$0.00 |
| 3074F |
|
287 |
270 |
$0.00 |
| 82962 |
|
18 |
16 |
$0.00 |
| 81001 |
|
15 |
14 |
$0.00 |
| 3017F |
|
27 |
25 |
$0.00 |
| G0010 |
Administration of hepatitis b vaccine |
22 |
22 |
$0.00 |
| 3075F |
|
38 |
37 |
$0.00 |
| 81000 |
|
14 |
13 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
13 |
13 |
$0.00 |
| 1101F |
|
13 |
13 |
$0.00 |
| 3044F |
|
13 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
13 |
$0.00 |