| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,851 |
5,736 |
$621K |
| 99401 |
|
3,950 |
2,293 |
$134K |
| 76818 |
|
1,112 |
430 |
$103K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
844 |
359 |
$58K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,113 |
901 |
$49K |
| 99406 |
|
2,553 |
1,604 |
$32K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
308 |
251 |
$32K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
535 |
501 |
$28K |
| 59025 |
Fetal non-stress test |
847 |
340 |
$27K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
201 |
169 |
$26K |
| 99234 |
|
220 |
149 |
$23K |
| 81025 |
|
2,022 |
1,739 |
$14K |
| 99199 |
Unlisted special service, procedure or report |
2,907 |
2,329 |
$14K |
| 81002 |
|
2,941 |
2,558 |
$8K |
| 87210 |
|
1,848 |
1,604 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89 |
75 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
59 |
51 |
$4K |
| 99215 |
Prolong outpt/office vis |
29 |
26 |
$3K |
| 85013 |
|
1,242 |
1,116 |
$3K |
| 99205 |
Prolong outpt/office vis |
16 |
15 |
$3K |
| 76801 |
|
26 |
25 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
33 |
28 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
916 |
812 |
$2K |
| 76830 |
Ultrasound, transvaginal |
14 |
12 |
$778.32 |
| G0310 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes) |
34 |
27 |
$765.25 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
12 |
$749.23 |
| 3511F |
|
295 |
273 |
$0.00 |
| 3015F |
|
130 |
123 |
$0.00 |
| 0500F |
|
32 |
28 |
$0.00 |
| 3008F |
|
161 |
151 |
$0.00 |