| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,033 |
8,175 |
$363K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
4,155 |
2,966 |
$210K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,772 |
4,625 |
$186K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,978 |
2,204 |
$178K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,309 |
1,660 |
$140K |
| 76801 |
|
1,647 |
1,172 |
$101K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,222 |
1,479 |
$99K |
| 90715 |
|
1,467 |
1,118 |
$49K |
| 59025 |
Fetal non-stress test |
1,101 |
521 |
$33K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,288 |
1,035 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
412 |
352 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,868 |
1,464 |
$19K |
| 81025 |
|
4,660 |
3,130 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
403 |
281 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
310 |
264 |
$17K |
| 99385 |
|
155 |
88 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
313 |
239 |
$4K |
| 94729 |
|
198 |
162 |
$3K |
| 94726 |
|
157 |
125 |
$2K |
| 87428 |
|
36 |
33 |
$2K |
| 58300 |
|
17 |
12 |
$918.46 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
104 |
89 |
$670.03 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
14 |
$423.75 |
| 94010 |
|
39 |
27 |
$288.57 |
| 90686 |
|
16 |
13 |
$185.45 |
| 81002 |
|
97 |
42 |
$105.35 |
| 90680 |
|
16 |
12 |
$95.96 |
| 90474 |
|
16 |
12 |
$92.59 |
| 3008F |
|
8,406 |
6,104 |
$90.38 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$59.38 |
| 90677 |
|
14 |
13 |
$0.00 |
| 0502F |
|
15,332 |
9,260 |
$0.00 |