| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,401 |
10,575 |
$1.01M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,444 |
6,202 |
$487K |
| 99199 |
Unlisted special service, procedure or report |
74,872 |
46,138 |
$432K |
| 99215 |
Prolong outpt/office vis |
2,258 |
1,384 |
$221K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,509 |
754 |
$81K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
778 |
610 |
$65K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
667 |
407 |
$62K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
806 |
579 |
$55K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
708 |
507 |
$54K |
| 81025 |
|
5,734 |
3,632 |
$30K |
| 96127 |
|
6,409 |
4,534 |
$25K |
| 76801 |
|
346 |
214 |
$25K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
221 |
148 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
215 |
168 |
$19K |
| 96161 |
|
4,885 |
3,449 |
$15K |
| 99385 |
|
180 |
105 |
$14K |
| 96160 |
|
4,300 |
3,067 |
$14K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
548 |
316 |
$11K |
| 76830 |
Ultrasound, transvaginal |
155 |
102 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
172 |
93 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
151 |
103 |
$11K |
| D0145 |
Oral evaluation for a patient under three years of age |
361 |
275 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
829 |
477 |
$10K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
285 |
191 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
875 |
560 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
318 |
198 |
$8K |
| 99382 |
|
128 |
81 |
$8K |
| 99383 |
|
82 |
54 |
$7K |
| 99384 |
|
74 |
51 |
$7K |
| 59430 |
|
53 |
40 |
$7K |
| 99381 |
|
138 |
62 |
$6K |
| 99205 |
Prolong outpt/office vis |
45 |
31 |
$6K |
| D1206 |
Topical application of fluoride varnish |
397 |
299 |
$5K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
35 |
28 |
$4K |
| 92551 |
|
1,634 |
1,180 |
$4K |
| 81003 |
|
2,000 |
1,337 |
$3K |
| 76813 |
|
37 |
24 |
$3K |
| 99173 |
|
1,894 |
1,292 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
324 |
198 |
$2K |
| 99406 |
|
311 |
180 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
32 |
18 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
134 |
101 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
20 |
14 |
$2K |
| 59025 |
Fetal non-stress test |
45 |
27 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
37 |
14 |
$941.42 |
| 85018 |
|
386 |
280 |
$868.21 |
| 80305 |
|
167 |
74 |
$823.31 |
| 90715 |
|
42 |
25 |
$635.73 |
| 99051 |
|
43 |
26 |
$513.60 |
| 87210 |
|
160 |
90 |
$411.20 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
27 |
24 |
$381.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
26 |
$368.80 |
| 90651 |
|
44 |
20 |
$260.44 |
| 99408 |
|
15 |
12 |
$235.47 |
| 82962 |
|
111 |
79 |
$173.40 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
301 |
216 |
$0.00 |
| 90633 |
|
107 |
63 |
$0.00 |
| 3078F |
|
35 |
32 |
$0.00 |
| 3077F |
|
92 |
79 |
$0.00 |
| 90734 |
|
31 |
17 |
$0.00 |
| 90670 |
|
198 |
110 |
$0.00 |
| 3080F |
|
107 |
94 |
$0.00 |
| 90716 |
|
21 |
12 |
$0.00 |
| 90680 |
|
61 |
30 |
$0.00 |
| 3074F |
|
51 |
47 |
$0.00 |
| 3075F |
|
14 |
13 |
$0.00 |
| 3079F |
|
15 |
14 |
$0.00 |
| 90697 |
|
34 |
16 |
$0.00 |