| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,015 |
10,170 |
$505K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,583 |
3,182 |
$222K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
539 |
535 |
$42K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
373 |
348 |
$27K |
| 81002 |
|
8,522 |
6,523 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
258 |
250 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,509 |
1,116 |
$19K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
30 |
30 |
$18K |
| 99000 |
|
1,627 |
1,517 |
$17K |
| 81025 |
|
2,223 |
2,130 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
123 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,549 |
1,353 |
$11K |
| 87428 |
|
148 |
140 |
$9K |
| 92551 |
|
938 |
925 |
$9K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
317 |
309 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
135 |
133 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
73 |
69 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
65 |
58 |
$6K |
| 59430 |
|
68 |
65 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
303 |
284 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
127 |
123 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
49 |
48 |
$4K |
| 90461 |
|
335 |
295 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
266 |
258 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
199 |
197 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
194 |
194 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
108 |
52 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$1K |
| 99385 |
|
12 |
12 |
$836.93 |
| 90715 |
|
19 |
19 |
$602.11 |
| 99173 |
|
1,152 |
1,136 |
$465.00 |
| 59025 |
Fetal non-stress test |
16 |
13 |
$433.61 |
| 99201 |
|
13 |
13 |
$320.54 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
81 |
77 |
$251.76 |
| 96160 |
|
74 |
74 |
$200.66 |
| 96161 |
|
43 |
39 |
$2.53 |
| 90686 |
|
406 |
398 |
$0.00 |
| 96127 |
|
611 |
544 |
$0.00 |
| 90688 |
|
140 |
138 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 90670 |
|
36 |
36 |
$0.00 |