| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,887 |
4,148 |
$273K |
| 76830 |
Ultrasound, transvaginal |
633 |
599 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
500 |
474 |
$25K |
| 59025 |
Fetal non-stress test |
770 |
278 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
277 |
273 |
$17K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
192 |
116 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
113 |
83 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
41 |
37 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$966.14 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
13 |
$603.61 |
| 99401 |
|
16 |
14 |
$410.18 |
| 81025 |
|
39 |
37 |
$245.20 |