| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
75,282 |
40,385 |
$504K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,219 |
3,689 |
$224K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,593 |
2,885 |
$186K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
248 |
215 |
$32K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
185 |
174 |
$15K |
| 99460 |
|
128 |
124 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
598 |
478 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
93 |
85 |
$9K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
129 |
127 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
33 |
32 |
$4K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
13 |
13 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
40 |
38 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
85 |
41 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
31 |
25 |
$801.58 |
| 20610 |
|
13 |
12 |
$616.82 |
| 90686 |
|
194 |
149 |
$520.90 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
15 |
13 |
$434.36 |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
28 |
13 |
$400.00 |
| 99441 |
|
17 |
12 |
$265.21 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
28 |
27 |
$228.97 |
| 96127 |
|
90 |
83 |
$197.75 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$169.56 |
| 81003 |
|
55 |
39 |
$64.68 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
12 |
$32.40 |
| 81002 |
|
18 |
12 |
$9.45 |
| 1160F |
|
182 |
168 |
$0.00 |
| 3078F |
|
31 |
30 |
$0.00 |
| 3074F |
|
49 |
45 |
$0.00 |