| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,700 |
1,576 |
$76K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
481 |
480 |
$39K |
| 99385 |
|
153 |
153 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
130 |
126 |
$9K |
| 81002 |
|
2,879 |
1,798 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
87 |
87 |
$5K |
| 76830 |
Ultrasound, transvaginal |
40 |
40 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
52 |
52 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
35 |
29 |
$2K |
| 81025 |
|
185 |
181 |
$1K |
| 59025 |
Fetal non-stress test |
35 |
12 |
$960.42 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
17 |
14 |
$831.81 |
| 87210 |
|
162 |
124 |
$616.76 |
| 96127 |
|
216 |
208 |
$579.80 |
| 90686 |
|
13 |
12 |
$223.93 |
| 83986 |
|
141 |
136 |
$209.63 |
| 82120 |
|
109 |
106 |
$118.12 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$77.00 |