| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,138 |
3,599 |
$157K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
898 |
776 |
$51K |
| 76830 |
Ultrasound, transvaginal |
318 |
307 |
$26K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
306 |
301 |
$25K |
| 59025 |
Fetal non-stress test |
540 |
325 |
$19K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
165 |
164 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
76 |
70 |
$6K |
| 99235 |
|
27 |
27 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
26 |
26 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
98 |
94 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
38 |
27 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
29 |
29 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
212 |
206 |
$1K |
| 81025 |
|
232 |
203 |
$1K |
| 76801 |
|
18 |
12 |
$872.72 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
12 |
12 |
$826.05 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
13 |
$702.86 |
| 90658 |
|
56 |
53 |
$569.47 |
| 90688 |
|
35 |
35 |
$525.31 |
| 87210 |
|
30 |
29 |
$118.03 |
| 76376 |
|
17 |
14 |
$79.92 |