| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,922 |
9,354 |
$1.28M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,792 |
6,478 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,633 |
3,849 |
$81K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,313 |
946 |
$45K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,380 |
1,036 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,270 |
941 |
$28K |
| 59510 |
|
34 |
14 |
$23K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
957 |
894 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,119 |
1,049 |
$14K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,657 |
1,379 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
476 |
358 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,286 |
1,601 |
$9K |
| 84443 |
Thyroid stimulating hormone (TSH) |
558 |
463 |
$9K |
| 80061 |
Lipid panel |
876 |
756 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,107 |
920 |
$8K |
| 76801 |
|
196 |
148 |
$7K |
| 90648 |
|
860 |
760 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
3,708 |
3,009 |
$5K |
| 90670 |
|
729 |
641 |
$5K |
| 87807 |
|
385 |
358 |
$4K |
| 90723 |
|
585 |
510 |
$4K |
| 80076 |
|
709 |
599 |
$4K |
| 90686 |
|
484 |
444 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
166 |
128 |
$4K |
| 90680 |
|
454 |
404 |
$3K |
| 80053 |
Comprehensive metabolic panel |
379 |
298 |
$3K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
64 |
55 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
59 |
35 |
$3K |
| 99173 |
|
1,439 |
1,127 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
242 |
219 |
$2K |
| 82950 |
|
408 |
330 |
$2K |
| 92551 |
|
789 |
599 |
$2K |
| G9357 |
Post-partum screenings, evaluations and education performed |
42 |
25 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
771 |
594 |
$2K |
| 81001 |
|
515 |
431 |
$2K |
| 90682 |
|
61 |
48 |
$1K |
| 80306 |
|
111 |
97 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
81 |
56 |
$1K |
| 90677 |
|
137 |
134 |
$1K |
| 83655 |
|
78 |
71 |
$1K |
| 86403 |
|
122 |
102 |
$1K |
| 90633 |
|
113 |
113 |
$896.00 |
| 96127 |
|
1,091 |
868 |
$884.01 |
| 59025 |
Fetal non-stress test |
51 |
14 |
$806.00 |
| 86850 |
|
133 |
104 |
$791.76 |
| 84439 |
|
81 |
73 |
$558.00 |
| 87340 |
|
65 |
42 |
$517.55 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
65 |
55 |
$432.29 |
| D1206 |
Topical application of fluoride varnish |
290 |
174 |
$417.60 |
| 90710 |
|
53 |
52 |
$408.00 |
| 87081 |
|
62 |
49 |
$363.08 |
| 86900 |
|
179 |
104 |
$352.80 |
| 90656 |
|
25 |
25 |
$292.45 |
| 99215 |
Prolong outpt/office vis |
248 |
207 |
$218.00 |
| 90649 |
|
19 |
14 |
$104.00 |
| 85018 |
|
61 |
49 |
$72.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
52 |
$70.04 |
| 81025 |
|
35 |
25 |
$59.72 |
| 85014 |
|
52 |
40 |
$51.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
62 |
50 |
$19.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
13 |
12 |
$3.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
30 |
26 |
$0.96 |
| 3078F |
|
53 |
49 |
$0.00 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
30 |
14 |
$0.00 |
| 3074F |
|
48 |
46 |
$0.00 |