| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,985 |
10,011 |
$490K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,425 |
2,287 |
$195K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
111 |
109 |
$64K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
649 |
628 |
$64K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,353 |
1,166 |
$57K |
| 59430 |
|
378 |
367 |
$36K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
380 |
372 |
$29K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
409 |
395 |
$28K |
| 59514 |
|
43 |
39 |
$23K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
306 |
292 |
$14K |
| 59025 |
Fetal non-stress test |
193 |
96 |
$6K |
| 76830 |
Ultrasound, transvaginal |
56 |
52 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
346 |
328 |
$4K |
| 90715 |
|
81 |
81 |
$3K |
| 82950 |
|
620 |
605 |
$2K |
| 99205 |
Prolong outpt/office vis |
14 |
14 |
$1K |
| 99234 |
|
12 |
12 |
$1K |
| 90658 |
|
62 |
60 |
$1K |
| 85018 |
|
620 |
605 |
$972.15 |
| 90688 |
|
16 |
16 |
$248.24 |
| 0502F |
|
265 |
208 |
$0.00 |