| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
4,436 |
3,643 |
$491K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,925 |
21,124 |
$256K |
| 59425 |
|
1,755 |
1,292 |
$197K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,703 |
7,313 |
$134K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,180 |
1,173 |
$89K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
781 |
778 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,628 |
2,479 |
$63K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
145 |
144 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,255 |
1,216 |
$27K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
473 |
468 |
$22K |
| 90670 |
|
1,958 |
1,904 |
$18K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
210 |
128 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,321 |
2,273 |
$12K |
| 90680 |
|
1,207 |
1,165 |
$11K |
| 90698 |
|
1,185 |
1,162 |
$11K |
| 99460 |
|
189 |
185 |
$10K |
| 99233 |
Prolong inpt eval add15 m |
234 |
100 |
$10K |
| 76801 |
|
165 |
99 |
$10K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
216 |
207 |
$9K |
| 90744 |
|
983 |
965 |
$9K |
| 99215 |
Prolong outpt/office vis |
40 |
40 |
$8K |
| 90633 |
|
839 |
825 |
$8K |
| 90686 |
|
669 |
667 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
936 |
932 |
$5K |
| H1000 |
Prenatal care, at-risk assessment |
16 |
16 |
$4K |
| 99205 |
Prolong outpt/office vis |
29 |
29 |
$3K |
| 81003 |
|
782 |
554 |
$3K |
| 90671 |
|
204 |
195 |
$3K |
| 31575 |
|
26 |
25 |
$2K |
| 59430 |
|
17 |
15 |
$2K |
| 90710 |
|
225 |
222 |
$2K |
| 99245 |
|
12 |
12 |
$2K |
| 90700 |
|
212 |
210 |
$2K |
| 90715 |
|
111 |
110 |
$2K |
| 20610 |
|
24 |
24 |
$2K |
| 90696 |
|
176 |
176 |
$2K |
| 81025 |
|
306 |
302 |
$2K |
| 90707 |
|
150 |
146 |
$1K |
| 90716 |
|
132 |
126 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
38 |
38 |
$1K |
| 99462 |
|
37 |
27 |
$1K |
| 81002 |
|
245 |
148 |
$929.81 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
32 |
27 |
$887.64 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$704.88 |
| 90688 |
|
40 |
40 |
$674.50 |
| 0011A |
|
14 |
14 |
$560.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
26 |
$528.00 |
| 0012A |
|
14 |
14 |
$520.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
136 |
133 |
$463.84 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
272 |
267 |
$393.17 |
| 90651 |
|
43 |
43 |
$387.00 |
| 87430 |
|
33 |
32 |
$253.58 |
| 90734 |
|
28 |
28 |
$252.00 |
| 90648 |
|
27 |
27 |
$243.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
100 |
99 |
$219.32 |
| 90474 |
|
41 |
41 |
$136.11 |
| 90685 |
|
14 |
14 |
$126.00 |
| 92551 |
|
83 |
83 |
$123.42 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
12 |
12 |
$64.38 |
| 85018 |
|
205 |
205 |
$47.15 |
| 90694 |
|
12 |
12 |
$0.00 |