| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,225 |
8,881 |
$430K |
| 59426 |
|
2,097 |
1,134 |
$189K |
| 59425 |
|
2,111 |
1,621 |
$181K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,539 |
1,370 |
$80K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,326 |
2,012 |
$69K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,028 |
909 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
792 |
664 |
$48K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
879 |
826 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,723 |
1,302 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
300 |
265 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
225 |
188 |
$16K |
| 81003 |
|
9,960 |
6,686 |
$15K |
| 99460 |
|
263 |
210 |
$12K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
13 |
13 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,282 |
1,109 |
$10K |
| 59410 |
|
13 |
12 |
$10K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
195 |
159 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
66 |
64 |
$6K |
| 81025 |
|
1,193 |
1,024 |
$6K |
| 59025 |
Fetal non-stress test |
191 |
155 |
$4K |
| 99385 |
|
44 |
39 |
$3K |
| 99462 |
|
117 |
86 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
197 |
138 |
$2K |
| 90715 |
|
44 |
42 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
25 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
13 |
$1K |
| 99381 |
|
49 |
38 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
63 |
57 |
$952.67 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
78 |
70 |
$716.73 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
15 |
$687.53 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
66 |
47 |
$494.76 |
| 90686 |
|
251 |
187 |
$436.74 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
119 |
101 |
$349.80 |
| D1206 |
Topical application of fluoride varnish |
15 |
14 |
$279.30 |
| 90670 |
|
417 |
365 |
$221.79 |
| 87807 |
|
20 |
16 |
$185.75 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
12 |
12 |
$99.92 |
| 83655 |
|
14 |
13 |
$74.82 |
| 90647 |
|
31 |
30 |
$55.00 |
| 99173 |
|
31 |
24 |
$48.48 |
| 90461 |
|
61 |
40 |
$10.07 |
| 90698 |
|
342 |
293 |
$7.50 |
| 85018 |
|
13 |
12 |
$2.44 |
| 90681 |
|
60 |
58 |
$0.00 |
| 90685 |
|
143 |
115 |
$0.00 |
| 90633 |
|
39 |
37 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
13 |
13 |
$0.00 |
| 0503F |
|
3,738 |
2,400 |
$0.00 |
| 0500F |
|
13 |
13 |
$0.00 |
| 90680 |
|
255 |
217 |
$0.00 |
| 90744 |
|
74 |
58 |
$0.00 |
| 90723 |
|
45 |
44 |
$0.00 |