| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Z1034 |
|
15,960 |
11,106 |
$989K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56,284 |
48,711 |
$641K |
| Z1032 |
|
2,546 |
2,546 |
$405K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
6,047 |
5,999 |
$382K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
39,386 |
35,760 |
$379K |
| J3490 |
Unclassified drugs |
12,244 |
10,838 |
$240K |
| 59514 |
|
4,646 |
4,070 |
$206K |
| Z6500 |
|
1,423 |
1,423 |
$178K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,920 |
4,366 |
$166K |
| 59425 |
|
32,708 |
22,710 |
$112K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
60,644 |
40,150 |
$86K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
283 |
275 |
$79K |
| 81025 |
|
118,067 |
101,863 |
$72K |
| Z6400 |
|
3,735 |
3,559 |
$72K |
| 90715 |
|
6,396 |
6,115 |
$46K |
| 99215 |
Prolong outpt/office vis |
3,400 |
3,371 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,732 |
4,217 |
$38K |
| Z6410 |
|
3,241 |
2,438 |
$25K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,262 |
5,217 |
$25K |
| H1000 |
Prenatal care, at-risk assessment |
7,171 |
7,121 |
$24K |
| H2000 |
Comprehensive multidisciplinary evaluation |
3,032 |
3,008 |
$22K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
26,041 |
20,125 |
$17K |
| 11981 |
|
198 |
189 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,083 |
961 |
$16K |
| 59430 |
|
9,151 |
6,542 |
$16K |
| 57454 |
|
2,024 |
1,016 |
$14K |
| A4267 |
Contraceptive supply, condom, male, each |
817 |
814 |
$12K |
| 99385 |
|
1,079 |
1,065 |
$12K |
| Z1038 |
|
310 |
197 |
$12K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
7,070 |
6,948 |
$9K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
19,831 |
14,451 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,725 |
1,714 |
$7K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
3,169 |
3,157 |
$7K |
| 51784 |
|
1,906 |
464 |
$6K |
| 58300 |
|
505 |
264 |
$4K |
| 90656 |
|
574 |
524 |
$4K |
| 91122 |
|
938 |
444 |
$4K |
| 51701 |
|
189 |
55 |
$4K |
| 99401 |
|
4,599 |
4,499 |
$4K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,225 |
1,208 |
$3K |
| 81002 |
|
9,797 |
6,884 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
34 |
26 |
$3K |
| 90674 |
|
318 |
316 |
$2K |
| 90686 |
|
419 |
408 |
$2K |
| 99386 |
|
167 |
166 |
$2K |
| 59025 |
Fetal non-stress test |
1,749 |
1,618 |
$1K |
| 97750 |
|
904 |
427 |
$1K |
| Z6406 |
|
125 |
122 |
$1K |
| 90688 |
|
185 |
185 |
$1K |
| 97803 |
|
3,422 |
3,360 |
$883.19 |
| Z6204 |
|
110 |
107 |
$859.24 |
| Z6304 |
|
105 |
103 |
$807.77 |
| 58301 |
|
176 |
88 |
$774.76 |
| 96156 |
|
3,900 |
3,868 |
$650.50 |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
15 |
12 |
$582.19 |
| 97032 |
|
933 |
440 |
$519.52 |
| J1644 |
Injection, heparin sodium, per 1000 units |
62 |
27 |
$499.77 |
| 96151 |
|
1,102 |
1,076 |
$482.37 |
| 87481 |
|
358 |
356 |
$383.88 |
| 11976 |
|
74 |
38 |
$350.01 |
| 58100 |
|
419 |
214 |
$304.47 |
| 97802 |
|
579 |
552 |
$278.07 |
| 87511 |
|
357 |
356 |
$218.04 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
357 |
356 |
$170.28 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
357 |
356 |
$168.10 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
390 |
389 |
$155.45 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
390 |
389 |
$154.95 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
144 |
136 |
$114.48 |
| S9452 |
Nutrition classes, non-physician provider, per session |
1,149 |
1,140 |
$88.33 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
448 |
448 |
$45.67 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
53 |
53 |
$36.80 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
106 |
106 |
$22.21 |
| S0197 |
Prenatal vitamins, 30-day supply |
25 |
25 |
$21.60 |
| 96150 |
|
185 |
181 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
27 |
13 |
$0.00 |
| 86580 |
|
19 |
13 |
$0.00 |
| 64566 |
|
96 |
25 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
20 |
12 |
$0.00 |
| T1024 |
Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter |
32 |
16 |
$0.00 |
| 96152 |
|
133 |
132 |
$0.00 |
| 21034 |
|
16 |
16 |
$0.00 |