| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
6,459 |
3,245 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
562 |
402 |
$27K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
378 |
288 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
64 |
53 |
$5K |
| 59025 |
Fetal non-stress test |
126 |
65 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
25 |
24 |
$2K |
| 76801 |
|
16 |
12 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
76 |
66 |
$904.55 |
| 81025 |
|
74 |
61 |
$479.81 |
| 90686 |
|
47 |
39 |
$443.80 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
12 |
$138.23 |
| 81002 |
|
150 |
103 |
$133.10 |