| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
421 |
396 |
$24K |
| 59425 |
|
53 |
52 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
275 |
255 |
$10K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
795 |
787 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
94 |
93 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
122 |
116 |
$7K |
| 87660 |
|
120 |
119 |
$3K |
| 87510 |
|
120 |
119 |
$3K |
| 87480 |
|
120 |
119 |
$3K |
| 81025 |
|
332 |
321 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
24 |
24 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
24 |
24 |
$2K |
| 76801 |
|
26 |
24 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
22 |
13 |
$2K |
| 76818 |
|
22 |
13 |
$1K |
| A4550 |
Surgical trays |
29 |
26 |
$1K |
| 99000 |
|
438 |
421 |
$1K |
| 76830 |
Ultrasound, transvaginal |
16 |
16 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$856.22 |
| 59025 |
Fetal non-stress test |
16 |
13 |
$421.32 |