| Code | Description | Claims | Beneficiaries | Total Paid |
| 99199 |
Unlisted special service, procedure or report |
53,836 |
29,613 |
$329K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,249 |
5,266 |
$289K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,466 |
1,258 |
$91K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
787 |
695 |
$35K |
| 76830 |
Ultrasound, transvaginal |
432 |
378 |
$28K |
| 59025 |
Fetal non-stress test |
1,007 |
765 |
$20K |
| 36415 |
Collection of venous blood by venipuncture |
6,671 |
5,586 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
139 |
127 |
$10K |
| 99401 |
|
257 |
196 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
84 |
69 |
$7K |
| 99218 |
|
103 |
95 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
81 |
61 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
55 |
53 |
$4K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
41 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
184 |
163 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
15 |
13 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$2K |
| 90674 |
|
89 |
80 |
$2K |
| 87210 |
|
448 |
382 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
53 |
43 |
$1K |
| 99459 |
|
125 |
116 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$931.44 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
12 |
12 |
$775.32 |
| 81025 |
|
115 |
83 |
$688.41 |
| 99222 |
Initial hospital care, per day, moderate complexity |
14 |
12 |
$675.06 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
12 |
$530.29 |
| 82950 |
|
26 |
25 |
$131.52 |
| 85018 |
|
15 |
12 |
$28.45 |
| 81002 |
|
14 |
14 |
$15.78 |
| 99072 |
|
309 |
280 |
$0.00 |
| 0502F |
|
648 |
552 |
$0.00 |
| 0503F |
|
17 |
13 |
$0.00 |
| 99000 |
|
1,715 |
1,480 |
$0.00 |
| 0501F |
|
14 |
12 |
$0.00 |