| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,480 |
3,468 |
$779K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
594 |
569 |
$124K |
| 81003 |
|
2,785 |
1,766 |
$61K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
425 |
419 |
$50K |
| 81025 |
|
1,007 |
888 |
$32K |
| 59430 |
|
28 |
28 |
$12K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
44 |
43 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
49 |
49 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$604.80 |