| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Z1034 |
|
6,758 |
5,014 |
$409K |
| Z1032 |
|
1,484 |
1,484 |
$198K |
| Z6500 |
|
1,499 |
1,499 |
$185K |
| 99381 |
|
774 |
774 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,492 |
2,257 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
688 |
688 |
$71K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,400 |
1,400 |
$65K |
| Z6400 |
|
2,692 |
2,607 |
$40K |
| Z6406 |
|
3,249 |
2,857 |
$34K |
| Z6204 |
|
3,515 |
3,018 |
$32K |
| Z6410 |
|
2,358 |
2,042 |
$31K |
| 76801 |
|
380 |
377 |
$28K |
| 76813 |
|
244 |
196 |
$24K |
| Z6304 |
|
2,451 |
2,177 |
$24K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
157 |
154 |
$13K |
| 99000 |
|
4,151 |
3,857 |
$12K |
| 81025 |
|
1,094 |
1,094 |
$9K |
| 90698 |
|
760 |
759 |
$7K |
| 90680 |
|
636 |
635 |
$6K |
| 90744 |
|
533 |
533 |
$5K |
| 90670 |
|
410 |
409 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
953 |
860 |
$2K |
| Z6414 |
|
116 |
111 |
$1K |
| 92552 |
|
12 |
12 |
$360.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$348.06 |
| Z6208 |
|
41 |
39 |
$320.98 |
| 90633 |
|
27 |
27 |
$213.75 |
| 90700 |
|
16 |
16 |
$144.00 |
| 90648 |
|
14 |
14 |
$126.00 |
| 92551 |
|
167 |
167 |
$122.28 |
| 92015 |
Determination of refractive state |
12 |
12 |
$95.16 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
943 |
626 |
$71.85 |
| 99173 |
|
118 |
117 |
$20.24 |
| 81000 |
|
40 |
38 |
$15.48 |
| 59425 |
|
112 |
77 |
$0.00 |
| 1160F |
|
703 |
624 |
$0.00 |
| 3078F |
|
890 |
810 |
$0.00 |
| 97803 |
|
111 |
101 |
$0.00 |
| 1159F |
|
823 |
735 |
$0.00 |
| 3077F |
|
126 |
113 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
42 |
42 |
$0.00 |
| 99401 |
|
129 |
117 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
57 |
53 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$0.00 |
| 96156 |
|
80 |
71 |
$0.00 |
| 1126F |
|
783 |
700 |
$0.00 |
| 3079F |
|
95 |
91 |
$0.00 |
| 3008F |
|
245 |
219 |
$0.00 |
| 3080F |
|
571 |
513 |
$0.00 |
| 3074F |
|
333 |
304 |
$0.00 |
| 1220F |
|
83 |
83 |
$0.00 |
| 1125F |
|
139 |
126 |
$0.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
39 |
26 |
$0.00 |