| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,095 |
6,728 |
$390K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,979 |
1,334 |
$101K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
848 |
692 |
$61K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
646 |
562 |
$36K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
32 |
24 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
154 |
125 |
$11K |
| 59430 |
|
76 |
75 |
$7K |
| 81025 |
|
1,072 |
888 |
$5K |
| 59025 |
Fetal non-stress test |
357 |
155 |
$4K |
| 76801 |
|
31 |
29 |
$2K |
| 81002 |
|
1,225 |
962 |
$2K |
| 76830 |
Ultrasound, transvaginal |
34 |
25 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
24 |
13 |
$195.24 |
| 3074F |
|
154 |
102 |
$15.00 |
| 87210 |
|
13 |
12 |
$4.24 |
| 99000 |
|
2,964 |
2,348 |
$0.00 |
| 3075F |
|
19 |
16 |
$0.00 |