| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,740 |
4,320 |
$292K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
172 |
166 |
$239K |
| 99199 |
Unlisted special service, procedure or report |
34,000 |
19,678 |
$202K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,722 |
1,335 |
$133K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,380 |
1,098 |
$122K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
722 |
495 |
$77K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
780 |
647 |
$75K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
946 |
684 |
$57K |
| 76801 |
|
705 |
560 |
$57K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,152 |
973 |
$49K |
| 59025 |
Fetal non-stress test |
913 |
545 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
929 |
653 |
$14K |
| 99215 |
Prolong outpt/office vis |
88 |
67 |
$9K |
| 81025 |
|
1,413 |
1,166 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
51 |
40 |
$5K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
63 |
28 |
$4K |
| 90715 |
|
107 |
92 |
$4K |
| 87210 |
|
922 |
761 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
190 |
153 |
$3K |
| 82120 |
|
706 |
607 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
217 |
190 |
$3K |
| 99401 |
|
95 |
76 |
$2K |
| 82947 |
|
462 |
400 |
$2K |
| 76830 |
Ultrasound, transvaginal |
30 |
27 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
21 |
$1K |
| 81002 |
|
398 |
366 |
$965.49 |
| 58300 |
|
17 |
12 |
$650.54 |
| 90686 |
|
43 |
32 |
$479.95 |
| 36415 |
Collection of venous blood by venipuncture |
85 |
78 |
$195.84 |
| 3078F |
|
557 |
368 |
$0.00 |
| 1160F |
|
1,127 |
754 |
$0.00 |
| 99072 |
|
642 |
420 |
$0.00 |
| 3015F |
|
21 |
20 |
$0.00 |
| 3077F |
|
69 |
47 |
$0.00 |
| 3008F |
|
1,082 |
730 |
$0.00 |
| 3075F |
|
95 |
71 |
$0.00 |
| 1036F |
|
766 |
492 |
$0.00 |
| 2000F |
|
342 |
252 |
$0.00 |
| 3080F |
|
43 |
29 |
$0.00 |
| 3074F |
|
660 |
441 |
$0.00 |
| 3079F |
|
158 |
111 |
$0.00 |