| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,175 |
15,842 |
$681K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,283 |
6,357 |
$357K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,767 |
1,774 |
$81K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,543 |
1,298 |
$74K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
900 |
772 |
$50K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
599 |
569 |
$25K |
| 95886 |
|
673 |
622 |
$22K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
204 |
171 |
$18K |
| 11721 |
|
2,024 |
1,710 |
$16K |
| 71046 |
Radiologic examination, chest; 2 views |
2,111 |
1,897 |
$14K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
565 |
524 |
$14K |
| 99215 |
Prolong outpt/office vis |
403 |
370 |
$13K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
585 |
542 |
$13K |
| 70450 |
Computed tomography, head or brain; without contrast material |
437 |
405 |
$10K |
| 99349 |
|
349 |
320 |
$9K |
| 99336 |
|
439 |
404 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
1,546 |
1,295 |
$7K |
| 73630 |
|
1,083 |
885 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
243 |
221 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
114 |
101 |
$7K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
166 |
158 |
$5K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
115 |
108 |
$4K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
301 |
287 |
$4K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
330 |
312 |
$4K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
50 |
45 |
$4K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
615 |
530 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
339 |
272 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
66 |
58 |
$3K |
| 95911 |
|
27 |
27 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
134 |
115 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
148 |
140 |
$2K |
| 76830 |
Ultrasound, transvaginal |
66 |
65 |
$2K |
| 81025 |
|
202 |
183 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
98 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
41 |
41 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
131 |
68 |
$947.89 |
| 11056 |
|
78 |
69 |
$863.74 |
| 95909 |
|
12 |
12 |
$862.02 |
| 99310 |
Prolong nursin fac eval 15m |
87 |
79 |
$858.71 |
| 72100 |
|
92 |
83 |
$680.50 |
| 90670 |
|
530 |
459 |
$603.21 |
| 74018 |
|
88 |
73 |
$560.16 |
| 73610 |
|
92 |
81 |
$467.58 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
12 |
$463.00 |
| 99406 |
|
265 |
240 |
$440.89 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
16 |
$421.94 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
12 |
$416.16 |
| 90648 |
|
543 |
492 |
$395.21 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
22 |
12 |
$333.59 |
| 73562 |
|
60 |
54 |
$310.33 |
| 99177 |
|
25 |
25 |
$264.14 |
| 90723 |
|
263 |
227 |
$245.08 |
| 73030 |
|
42 |
36 |
$216.02 |
| H1000 |
Prenatal care, at-risk assessment |
15 |
14 |
$174.28 |
| 90686 |
|
195 |
188 |
$166.66 |
| 93971 |
|
12 |
12 |
$159.38 |
| 51798 |
|
13 |
12 |
$114.65 |
| 73130 |
|
13 |
12 |
$93.02 |
| 81003 |
|
83 |
43 |
$86.19 |
| 81002 |
|
57 |
56 |
$76.94 |
| 36415 |
Collection of venous blood by venipuncture |
41 |
36 |
$75.25 |
| 73110 |
|
12 |
12 |
$65.45 |
| 73080 |
|
12 |
12 |
$44.58 |
| 90681 |
|
25 |
25 |
$40.00 |
| 90677 |
|
14 |
13 |
$0.06 |
| 90461 |
|
38 |
29 |
$0.00 |
| 90633 |
|
28 |
24 |
$0.00 |