| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
124 |
124 |
$97K |
| 59514 |
|
178 |
177 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
349 |
349 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
404 |
394 |
$30K |
| 59425 |
|
310 |
203 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,559 |
4,290 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,002 |
5,438 |
$16K |
| 90686 |
|
608 |
605 |
$11K |
| 90682 |
|
75 |
75 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
64 |
64 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
39 |
39 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
52 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
802 |
771 |
$3K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
97 |
80 |
$3K |
| 92552 |
|
95 |
95 |
$3K |
| 0013A |
|
55 |
55 |
$2K |
| 0012A |
|
53 |
53 |
$2K |
| 0011A |
|
45 |
45 |
$2K |
| Z1034 |
|
30 |
24 |
$2K |
| 90648 |
|
86 |
82 |
$2K |
| 90670 |
|
87 |
84 |
$2K |
| 96127 |
|
203 |
198 |
$1K |
| 90656 |
|
42 |
42 |
$1K |
| 90716 |
|
37 |
37 |
$903.38 |
| 90633 |
|
26 |
24 |
$468.00 |
| 0124A |
|
12 |
12 |
$440.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
104 |
104 |
$349.96 |
| 97803 |
|
13 |
13 |
$336.40 |
| 85018 |
|
144 |
137 |
$270.47 |
| 90651 |
|
13 |
13 |
$234.00 |
| 81003 |
|
140 |
138 |
$225.60 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25 |
12 |
$216.72 |
| 90734 |
|
12 |
12 |
$216.00 |
| 90662 |
|
132 |
132 |
$215.00 |
| 90723 |
|
12 |
12 |
$202.50 |
| 99070 |
|
109 |
108 |
$114.25 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
45 |
45 |
$16.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
188 |
184 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
73 |
73 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
166 |
166 |
$0.00 |