| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,005 |
1,595 |
$50K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
658 |
530 |
$22K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
300 |
236 |
$17K |
| 59426 |
|
15 |
15 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
42 |
40 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
51 |
43 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
44 |
41 |
$2K |
| 99215 |
Prolong outpt/office vis |
16 |
16 |
$2K |
| 99234 |
|
13 |
12 |
$1K |
| 81025 |
|
176 |
156 |
$871.61 |
| 81002 |
|
293 |
264 |
$687.97 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
12 |
12 |
$677.40 |
| 0502F |
|
2,253 |
1,578 |
$399.16 |
| 0503F |
|
344 |
156 |
$0.00 |