| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
25,692 |
18,592 |
$1.49M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,810 |
10,533 |
$1.16M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
10,703 |
9,957 |
$1.11M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,106 |
18,192 |
$1.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,952 |
9,245 |
$761K |
| 59430 |
|
1,490 |
1,402 |
$274K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,600 |
2,526 |
$256K |
| 59410 |
|
171 |
171 |
$195K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,639 |
1,564 |
$194K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
792 |
762 |
$132K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,985 |
9,436 |
$123K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
860 |
824 |
$105K |
| 99381 |
|
1,127 |
958 |
$89K |
| 76801 |
|
365 |
339 |
$56K |
| 99460 |
|
976 |
839 |
$54K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
10,272 |
9,034 |
$53K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,105 |
959 |
$48K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
336 |
328 |
$35K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,601 |
365 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,313 |
6,218 |
$24K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,975 |
5,846 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
882 |
836 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
244 |
239 |
$17K |
| 83655 |
|
3,175 |
3,091 |
$9K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
247 |
217 |
$8K |
| 54150 |
|
63 |
53 |
$7K |
| 99383 |
|
58 |
55 |
$5K |
| 99462 |
|
211 |
173 |
$5K |
| 90461 |
|
2,460 |
1,987 |
$5K |
| 59025 |
Fetal non-stress test |
61 |
41 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
892 |
849 |
$3K |
| 99233 |
Prolong inpt eval add15 m |
91 |
26 |
$3K |
| 76818 |
|
17 |
12 |
$3K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
14 |
13 |
$3K |
| 90474 |
|
1,165 |
1,124 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
40 |
39 |
$2K |
| 92567 |
|
275 |
260 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
12 |
$2K |
| 90670 |
|
3,023 |
2,709 |
$2K |
| 99219 |
|
16 |
16 |
$2K |
| 85018 |
|
3,406 |
3,319 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
320 |
301 |
$1K |
| 90723 |
|
2,283 |
2,096 |
$1K |
| 87807 |
|
458 |
441 |
$1K |
| 92557 |
|
43 |
37 |
$1K |
| 99385 |
|
12 |
12 |
$1K |
| 90686 |
|
533 |
517 |
$1K |
| 69210 |
|
27 |
25 |
$709.54 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
16 |
14 |
$654.24 |
| 90710 |
|
592 |
542 |
$579.79 |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
15 |
12 |
$560.76 |
| 76820 |
|
14 |
13 |
$463.96 |
| 99443 |
|
44 |
38 |
$420.22 |
| 81025 |
|
77 |
77 |
$397.14 |
| 92588 |
|
13 |
13 |
$392.30 |
| 90681 |
|
853 |
751 |
$385.15 |
| 81002 |
|
1,347 |
1,030 |
$350.88 |
| 90647 |
|
2,274 |
2,057 |
$337.52 |
| 90688 |
|
466 |
446 |
$312.53 |
| 96161 |
|
367 |
296 |
$211.87 |
| 90633 |
|
1,246 |
1,136 |
$157.02 |
| 3078F |
|
8,927 |
7,165 |
$53.19 |
| 81003 |
|
197 |
157 |
$48.94 |
| 99000 |
|
21 |
13 |
$15.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
12 |
12 |
$4.26 |
| 90700 |
|
90 |
88 |
$0.00 |
| 99173 |
|
1,858 |
1,668 |
$0.00 |
| 3725F |
|
238 |
172 |
$0.00 |
| 3074F |
|
9,465 |
7,625 |
$0.00 |
| 3079F |
|
601 |
493 |
$0.00 |
| 1036F |
|
209 |
161 |
$0.00 |
| 1126F |
|
237 |
213 |
$0.00 |
| 90696 |
|
18 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
179 |
175 |
$0.00 |
| 36416 |
|
201 |
187 |
$0.00 |
| 3075F |
|
121 |
103 |
$0.00 |
| 96127 |
|
48 |
37 |
$0.00 |