| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,595 |
2,539 |
$119K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,629 |
1,935 |
$116K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,050 |
976 |
$89K |
| 59430 |
|
347 |
323 |
$32K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
131 |
122 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
303 |
231 |
$7K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
97 |
67 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
51 |
51 |
$5K |
| 76813 |
|
24 |
24 |
$2K |
| 99215 |
Prolong outpt/office vis |
27 |
27 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$792.99 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$109.76 |