| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,526 |
1,399 |
$92K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
974 |
847 |
$76K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,206 |
2,633 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
766 |
649 |
$18K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
284 |
271 |
$11K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
141 |
119 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
102 |
96 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
105 |
99 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
137 |
119 |
$4K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
684 |
558 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
133 |
119 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
132 |
69 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
29 |
$1K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$1K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$1K |
| 96127 |
|
240 |
115 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
28 |
14 |
$932.78 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
130 |
105 |
$914.21 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
22 |
18 |
$784.01 |
| 71045 |
Radiologic examination, chest; single view |
196 |
152 |
$715.83 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
23 |
$561.05 |
| 99173 |
|
51 |
49 |
$472.80 |
| 71046 |
Radiologic examination, chest; 2 views |
73 |
68 |
$462.61 |
| 92552 |
|
24 |
24 |
$347.15 |
| 81025 |
|
32 |
29 |
$203.31 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
108 |
60 |
$181.88 |
| 90756 |
|
38 |
17 |
$147.54 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
12 |
$112.75 |
| 90656 |
|
15 |
12 |
$95.45 |
| 36415 |
Collection of venous blood by venipuncture |
83 |
74 |
$92.20 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
64 |
32 |
$83.40 |
| 81003 |
|
19 |
15 |
$37.38 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30 |
27 |
$21.05 |
| 80053 |
Comprehensive metabolic panel |
30 |
27 |
$13.46 |
| 81002 |
|
18 |
14 |
$5.24 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
570 |
391 |
$0.00 |
| 99490 |
Ccm add 20min |
22 |
19 |
$0.00 |
| 4040F |
|
240 |
192 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
76 |
59 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
194 |
154 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
147 |
129 |
$0.00 |
| 92015 |
Determination of refractive state |
66 |
57 |
$0.00 |
| 1159F |
|
185 |
111 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
16 |
15 |
$0.00 |
| 1160F |
|
90 |
57 |
$0.00 |
| 3078F |
|
145 |
83 |
$0.00 |
| 1003F |
|
101 |
50 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
64 |
51 |
$0.00 |
| 3048F |
|
263 |
187 |
$0.00 |
| 3008F |
|
625 |
464 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
42 |
26 |
$0.00 |
| 3044F |
|
530 |
357 |
$0.00 |
| 1036F |
|
193 |
150 |
$0.00 |
| 3074F |
|
166 |
96 |
$0.00 |
| 3079F |
|
21 |
14 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
17 |
13 |
$0.00 |
| 3049F |
|
28 |
12 |
$0.00 |
| 90686 |
|
27 |
25 |
$0.00 |