| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,621 |
2,330 |
$59K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
144 |
129 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
69 |
68 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
92 |
80 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
12 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
14 |
$957.54 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
39 |
$816.36 |
| 90756 |
|
38 |
38 |
$771.15 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$741.98 |
| 81025 |
|
75 |
73 |
$409.31 |