| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
531,158 |
522,444 |
$2.84M |
| 59426 |
|
930 |
885 |
$666K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,386 |
4,970 |
$182K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,228 |
7,473 |
$115K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,316 |
3,889 |
$112K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,499 |
1,358 |
$110K |
| 59510 |
|
73 |
69 |
$106K |
| 59025 |
Fetal non-stress test |
3,572 |
2,297 |
$100K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
5,124 |
4,719 |
$93K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
603 |
488 |
$85K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,697 |
1,530 |
$82K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
537 |
442 |
$61K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
425 |
372 |
$57K |
| 81025 |
|
6,917 |
6,285 |
$55K |
| 76801 |
|
500 |
432 |
$53K |
| 96127 |
|
13,242 |
11,658 |
$52K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
314 |
276 |
$40K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
28 |
28 |
$37K |
| 90715 |
|
2,503 |
2,227 |
$27K |
| 87210 |
|
2,420 |
2,011 |
$22K |
| 90651 |
|
1,396 |
1,231 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
5,908 |
5,157 |
$16K |
| 59425 |
|
25 |
25 |
$9K |
| 90734 |
|
974 |
919 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
106 |
96 |
$8K |
| 90620 |
|
576 |
473 |
$8K |
| 59430 |
|
58 |
58 |
$7K |
| 90686 |
|
1,585 |
1,509 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
425 |
190 |
$6K |
| 82950 |
|
1,047 |
974 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
51 |
$6K |
| 82947 |
|
985 |
610 |
$6K |
| 90480 |
|
101 |
98 |
$5K |
| 90619 |
|
1,738 |
1,444 |
$5K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
14 |
13 |
$5K |
| 90716 |
|
144 |
134 |
$4K |
| 82951 |
|
196 |
189 |
$3K |
| 99406 |
|
298 |
281 |
$3K |
| 96160 |
|
555 |
544 |
$2K |
| 11981 |
|
12 |
12 |
$1K |
| 99407 |
|
56 |
54 |
$1K |
| 81003 |
|
312 |
267 |
$807.46 |
| 90707 |
|
64 |
59 |
$684.19 |
| 82948 |
|
150 |
93 |
$513.17 |
| 85018 |
|
145 |
138 |
$394.38 |
| 90633 |
|
646 |
583 |
$358.00 |
| 91320 |
|
17 |
16 |
$355.35 |
| 90656 |
|
99 |
98 |
$231.02 |
| 90714 |
|
13 |
13 |
$230.10 |
| 90744 |
|
43 |
39 |
$69.60 |
| 90696 |
|
216 |
189 |
$54.00 |
| 90713 |
|
68 |
62 |
$33.00 |
| 90710 |
|
357 |
309 |
$0.00 |
| 90670 |
|
27 |
27 |
$0.00 |
| 91319 |
|
13 |
13 |
$0.00 |
| J1726 |
Injection, hydroxyprogesterone caproate, (makena), 10 mg |
67 |
25 |
$0.00 |