| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,866 |
1,446 |
$176K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,883 |
1,309 |
$121K |
| 99385 |
|
276 |
275 |
$29K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
252 |
227 |
$23K |
| 76830 |
Ultrasound, transvaginal |
212 |
212 |
$18K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
183 |
182 |
$15K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
101 |
101 |
$10K |
| 93976 |
|
80 |
80 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
46 |
46 |
$6K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$2K |
| 99000 |
|
1,127 |
1,123 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,133 |
1,054 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
20 |
12 |
$961.39 |
| 99072 |
|
163 |
132 |
$881.25 |
| 86703 |
|
12 |
12 |
$100.70 |
| 86592 |
|
12 |
12 |
$27.38 |