| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
27,189 |
22,027 |
$2.06M |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12,742 |
10,865 |
$1.79M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46,536 |
36,184 |
$1.68M |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15,809 |
10,238 |
$982K |
| 59025 |
Fetal non-stress test |
24,985 |
13,465 |
$704K |
| 99199 |
Unlisted special service, procedure or report |
76,518 |
33,043 |
$532K |
| 76820 |
|
12,916 |
6,771 |
$474K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,745 |
4,493 |
$445K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
294 |
247 |
$372K |
| 99234 |
|
3,515 |
2,788 |
$356K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
2,659 |
1,967 |
$297K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
5,072 |
2,100 |
$258K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,237 |
1,950 |
$228K |
| 97802 |
|
5,040 |
4,295 |
$198K |
| 76818 |
|
2,205 |
1,368 |
$173K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,496 |
3,069 |
$161K |
| 76801 |
|
1,633 |
1,391 |
$147K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,109 |
1,823 |
$146K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
3,271 |
2,745 |
$133K |
| 76821 |
|
1,720 |
1,010 |
$118K |
| 99243 |
|
1,146 |
928 |
$100K |
| 90715 |
|
2,601 |
2,177 |
$96K |
| 76813 |
|
857 |
800 |
$75K |
| 81003 |
|
44,493 |
33,629 |
$72K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,007 |
860 |
$71K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,805 |
4,079 |
$68K |
| 59410 |
|
94 |
75 |
$62K |
| 97803 |
|
2,149 |
1,799 |
$55K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,434 |
3,677 |
$54K |
| 76825 |
|
617 |
523 |
$46K |
| 81025 |
|
6,486 |
5,505 |
$42K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
712 |
620 |
$32K |
| 93325 |
|
923 |
765 |
$28K |
| 99242 |
|
338 |
320 |
$22K |
| 94150 |
|
1,046 |
759 |
$17K |
| 76827 |
|
658 |
555 |
$17K |
| 90686 |
|
1,077 |
931 |
$17K |
| 99222 |
Initial hospital care, per day, moderate complexity |
175 |
155 |
$16K |
| 59510 |
|
16 |
12 |
$16K |
| 85018 |
|
4,438 |
3,857 |
$11K |
| 99442 |
|
293 |
222 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
148 |
111 |
$9K |
| 99241 |
|
242 |
230 |
$8K |
| 99221 |
|
116 |
101 |
$8K |
| 76830 |
Ultrasound, transvaginal |
101 |
99 |
$7K |
| 90678 |
|
56 |
33 |
$6K |
| 99422 |
|
160 |
140 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
399 |
355 |
$6K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
118 |
97 |
$6K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
39 |
27 |
$5K |
| 99215 |
Prolong outpt/office vis |
47 |
46 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
43 |
36 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
134 |
113 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
30 |
29 |
$2K |
| 99441 |
|
118 |
94 |
$2K |
| 87210 |
|
555 |
502 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
40 |
40 |
$2K |
| 96127 |
|
498 |
469 |
$2K |
| 99417 |
Prolong home eval add 15m |
15 |
14 |
$1K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
15 |
15 |
$1K |
| 76826 |
|
25 |
25 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
74 |
67 |
$933.06 |
| 36415 |
Collection of venous blood by venipuncture |
413 |
364 |
$666.62 |
| 82962 |
|
193 |
147 |
$512.48 |
| 76828 |
|
25 |
25 |
$453.01 |
| 81002 |
|
224 |
168 |
$128.01 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15 |
12 |
$98.28 |
| 3078F |
|
155 |
151 |
$0.00 |
| 1160F |
|
489 |
479 |
$0.00 |
| 3074F |
|
317 |
310 |
$0.00 |
| 0500F |
|
1,016 |
975 |
$0.00 |
| 0503F |
|
297 |
293 |
$0.00 |
| 3079F |
|
50 |
49 |
$0.00 |
| 3075F |
|
13 |
13 |
$0.00 |