| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,956 |
1,580 |
$85K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,302 |
1,032 |
$82K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
50 |
41 |
$51K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
437 |
402 |
$41K |
| 99199 |
Unlisted special service, procedure or report |
10,717 |
10,528 |
$39K |
| 76801 |
|
360 |
332 |
$29K |
| 59025 |
Fetal non-stress test |
808 |
479 |
$21K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
382 |
350 |
$16K |
| 81025 |
|
1,475 |
1,276 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
403 |
355 |
$6K |
| 76830 |
Ultrasound, transvaginal |
118 |
98 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
132 |
107 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
42 |
28 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
25 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
154 |
97 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
182 |
143 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
776 |
620 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
12 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
14 |
14 |
$904.54 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
12 |
$881.78 |
| 90686 |
|
37 |
32 |
$514.46 |
| 90715 |
|
20 |
14 |
$491.48 |
| 81002 |
|
164 |
122 |
$276.10 |
| 96127 |
|
45 |
43 |
$170.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
12 |
12 |
$16.22 |
| 0502F |
|
272 |
238 |
$0.00 |