| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,151 |
866 |
$66K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
591 |
443 |
$46K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
281 |
241 |
$8K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
41 |
41 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
52 |
51 |
$5K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
52 |
48 |
$4K |
| 81000 |
|
992 |
611 |
$4K |
| 99215 |
Prolong outpt/office vis |
20 |
16 |
$2K |
| 76801 |
|
17 |
14 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
15 |
13 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
448 |
360 |
$755.36 |
| 99000 |
|
133 |
87 |
$0.00 |