| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Z1034 |
|
1,511 |
987 |
$83K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,683 |
19,695 |
$58K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,199 |
3,178 |
$53K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,182 |
3,165 |
$43K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
592 |
576 |
$35K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,094 |
9,468 |
$35K |
| 92551 |
|
11,172 |
11,150 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,623 |
1,607 |
$32K |
| 99401 |
|
866 |
847 |
$11K |
| J3490 |
Unclassified drugs |
201 |
176 |
$11K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
356 |
221 |
$10K |
| 85018 |
|
11,581 |
11,402 |
$8K |
| 81000 |
|
4,512 |
4,496 |
$5K |
| 90670 |
|
770 |
769 |
$5K |
| 90686 |
|
1,005 |
988 |
$5K |
| 0001A |
|
97 |
97 |
$4K |
| A4267 |
Contraceptive supply, condom, male, each |
316 |
314 |
$4K |
| 0072A |
|
87 |
87 |
$3K |
| 0002A |
|
67 |
67 |
$3K |
| 81025 |
|
902 |
887 |
$3K |
| 99402 |
|
83 |
83 |
$3K |
| 92081 |
|
3,115 |
3,114 |
$3K |
| Z1032 |
|
12 |
12 |
$2K |
| 90723 |
|
288 |
287 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
161 |
$2K |
| 90656 |
|
1,256 |
1,250 |
$2K |
| 0071A |
|
43 |
43 |
$2K |
| 90648 |
|
254 |
254 |
$2K |
| 99441 |
|
720 |
694 |
$2K |
| 90649 |
|
578 |
577 |
$2K |
| 99381 |
|
13 |
13 |
$2K |
| 0502F |
|
257 |
173 |
$2K |
| 90697 |
|
174 |
174 |
$1K |
| 90633 |
|
295 |
295 |
$1K |
| S0197 |
Prenatal vitamins, 30-day supply |
836 |
332 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
179 |
179 |
$1K |
| 92552 |
|
139 |
139 |
$1K |
| 90734 |
|
353 |
353 |
$1K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
5,403 |
5,400 |
$993.78 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
491 |
490 |
$980.91 |
| Z6400 |
|
68 |
68 |
$824.36 |
| 3008F |
|
10,749 |
10,705 |
$795.07 |
| 99173 |
|
4,812 |
4,806 |
$787.48 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
5,390 |
5,388 |
$765.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,648 |
5,641 |
$752.91 |
| 90710 |
|
96 |
96 |
$710.10 |
| 90685 |
|
194 |
193 |
$669.00 |
| 90651 |
|
97 |
97 |
$603.00 |
| 87110 |
|
116 |
116 |
$535.99 |
| 83026 |
|
183 |
182 |
$386.10 |
| 86580 |
|
563 |
556 |
$358.84 |
| 81002 |
|
5,519 |
5,502 |
$346.94 |
| 90716 |
|
35 |
35 |
$330.00 |
| 90707 |
|
35 |
35 |
$290.00 |
| 90700 |
|
34 |
34 |
$279.66 |
| 83655 |
|
57 |
57 |
$239.87 |
| 81003 |
|
96 |
96 |
$211.56 |
| 88150 |
|
76 |
76 |
$207.00 |
| 90715 |
|
82 |
82 |
$192.00 |
| 90681 |
|
24 |
24 |
$180.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
387 |
387 |
$169.27 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
50 |
50 |
$130.59 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
423 |
418 |
$82.48 |
| 90696 |
|
25 |
25 |
$79.00 |
| 87081 |
|
160 |
156 |
$30.85 |
| 90688 |
|
25 |
25 |
$18.00 |
| 96156 |
|
13 |
13 |
$8.41 |
| P3000 |
Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision |
186 |
185 |
$0.00 |
| 99385 |
|
13 |
13 |
$0.00 |
| 3079F |
|
13 |
12 |
$0.00 |
| 90733 |
|
13 |
12 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
3,599 |
3,596 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
106 |
102 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
82 |
82 |
$0.00 |
| 99442 |
|
180 |
177 |
$0.00 |