| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,927 |
19,486 |
$1.87M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,957 |
3,439 |
$454K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,541 |
2,379 |
$286K |
| 99215 |
Prolong outpt/office vis |
738 |
666 |
$112K |
| 76801 |
|
1,372 |
1,091 |
$111K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
8,625 |
6,635 |
$74K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
480 |
450 |
$59K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,052 |
719 |
$58K |
| 59430 |
|
345 |
310 |
$34K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
470 |
435 |
$31K |
| 99385 |
|
249 |
227 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
672 |
594 |
$28K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,156 |
1,015 |
$26K |
| H1000 |
Prenatal care, at-risk assessment |
499 |
437 |
$16K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
221 |
114 |
$15K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
178 |
154 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
866 |
808 |
$13K |
| 99235 |
|
78 |
63 |
$13K |
| 81002 |
|
4,674 |
3,791 |
$11K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
13 |
13 |
$11K |
| 99459 |
|
536 |
524 |
$11K |
| 81025 |
|
1,842 |
1,628 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$9K |
| 59025 |
Fetal non-stress test |
250 |
183 |
$9K |
| 99386 |
|
61 |
55 |
$8K |
| 59514 |
|
17 |
14 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
62 |
55 |
$6K |
| 99205 |
Prolong outpt/office vis |
50 |
34 |
$5K |
| 76818 |
|
52 |
27 |
$4K |
| 58300 |
|
58 |
53 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
29 |
27 |
$3K |
| 90715 |
|
90 |
77 |
$3K |
| 87210 |
|
244 |
229 |
$878.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
62 |
51 |
$512.16 |
| 90686 |
|
31 |
24 |
$429.57 |
| 96127 |
|
94 |
91 |
$425.12 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
13 |
$31.19 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
13 |
13 |
$19.80 |
| 0502F |
|
169 |
125 |
$0.00 |
| 0501F |
|
400 |
344 |
$0.00 |
| 99000 |
|
14 |
13 |
$0.00 |