| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,364 |
4,947 |
$272K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,146 |
6,116 |
$244K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,066 |
931 |
$164K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,653 |
2,523 |
$155K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,785 |
6,322 |
$141K |
| 99215 |
Prolong outpt/office vis |
7,210 |
5,549 |
$140K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,275 |
2,197 |
$139K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
922 |
906 |
$64K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
209 |
39 |
$56K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
825 |
803 |
$34K |
| 99460 |
|
405 |
394 |
$33K |
| 90461 |
|
3,796 |
1,979 |
$32K |
| 99233 |
Prolong inpt eval add15 m |
1,535 |
439 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
250 |
246 |
$20K |
| 93970 |
|
1,086 |
1,033 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
489 |
468 |
$11K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
367 |
224 |
$10K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
110 |
52 |
$9K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
99 |
25 |
$9K |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
25 |
12 |
$7K |
| 99464 |
|
113 |
113 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
364 |
348 |
$5K |
| 90670 |
|
1,188 |
944 |
$5K |
| 90677 |
|
46 |
36 |
$4K |
| 90686 |
|
1,131 |
1,003 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
44 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
101 |
91 |
$2K |
| 90716 |
|
150 |
114 |
$1K |
| 93971 |
|
149 |
147 |
$1K |
| 90681 |
|
468 |
382 |
$1K |
| 59430 |
|
18 |
18 |
$1K |
| 99223 |
Prolong inpt eval add15 m |
51 |
40 |
$1K |
| 90707 |
|
151 |
115 |
$1K |
| 90723 |
|
945 |
808 |
$1K |
| 76818 |
|
27 |
26 |
$898.15 |
| 99497 |
|
68 |
50 |
$824.92 |
| 99222 |
Initial hospital care, per day, moderate complexity |
17 |
13 |
$740.44 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$557.94 |
| 99218 |
|
12 |
12 |
$545.11 |
| 90734 |
|
19 |
13 |
$445.47 |
| 59025 |
Fetal non-stress test |
30 |
29 |
$433.96 |
| 90633 |
|
281 |
236 |
$396.85 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$390.67 |
| 90648 |
|
1,201 |
964 |
$385.03 |
| 96127 |
|
105 |
104 |
$363.06 |
| 90700 |
|
46 |
42 |
$115.84 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |