| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,917 |
2,480 |
$265K |
| 76828 |
|
1,841 |
1,076 |
$64K |
| 93325 |
|
1,629 |
1,001 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
478 |
442 |
$36K |
| 76820 |
|
850 |
451 |
$24K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
408 |
325 |
$21K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
304 |
223 |
$19K |
| 99215 |
Prolong outpt/office vis |
122 |
105 |
$11K |
| 59430 |
|
16 |
15 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
74 |
26 |
$3K |
| 99205 |
Prolong outpt/office vis |
15 |
13 |
$3K |
| 90686 |
|
153 |
103 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
39 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
112 |
79 |
$1K |
| 76827 |
|
14 |
12 |
$546.48 |
| 59025 |
Fetal non-stress test |
19 |
12 |
$230.67 |