| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99233 |
Prolong inpt eval add15 m |
4,945 |
1,757 |
$178K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
6,346 |
2,104 |
$160K |
| H1000 |
Prenatal care, at-risk assessment |
2,752 |
1,751 |
$152K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
786 |
228 |
$77K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,230 |
1,880 |
$77K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,269 |
1,751 |
$54K |
| 99223 |
Prolong inpt eval add15 m |
757 |
562 |
$45K |
| 76830 |
Ultrasound, transvaginal |
148 |
123 |
$15K |
| 99215 |
Prolong outpt/office vis |
170 |
135 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
86 |
65 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
92 |
85 |
$5K |
| 99255 |
|
46 |
46 |
$5K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
31 |
26 |
$3K |
| 59025 |
Fetal non-stress test |
100 |
69 |
$3K |
| 99221 |
|
36 |
26 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$811.07 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$640.98 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
14 |
12 |
$209.65 |
| 90688 |
|
23 |
17 |
$131.22 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
21 |
$104.00 |
| 51798 |
|
13 |
12 |
$70.68 |
| 81025 |
|
58 |
56 |
$54.60 |
| 3078F |
|
3,024 |
2,097 |
$0.00 |
| 3077F |
|
33 |
26 |
$0.00 |
| 3074F |
|
3,822 |
2,578 |
$0.00 |
| 3079F |
|
966 |
696 |
$0.00 |
| 1036F |
|
706 |
470 |
$0.00 |
| 3075F |
|
43 |
38 |
$0.00 |
| 1126F |
|
47 |
39 |
$0.00 |
| 3080F |
|
17 |
12 |
$0.00 |