| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
6,601 |
5,970 |
$726K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,938 |
5,764 |
$462K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
5,401 |
3,746 |
$435K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,483 |
2,478 |
$431K |
| 59025 |
Fetal non-stress test |
10,993 |
7,208 |
$418K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,659 |
757 |
$116K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
836 |
836 |
$114K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
895 |
895 |
$101K |
| 99205 |
Prolong outpt/office vis |
130 |
130 |
$28K |
| 54150 |
|
246 |
246 |
$24K |
| 76820 |
|
490 |
301 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
195 |
189 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
343 |
330 |
$18K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
103 |
103 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
101 |
101 |
$11K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
218 |
115 |
$10K |
| 76801 |
|
76 |
75 |
$9K |
| 99215 |
Prolong outpt/office vis |
44 |
44 |
$8K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
88 |
86 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
52 |
49 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
52 |
52 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
27 |
27 |
$3K |
| 76830 |
Ultrasound, transvaginal |
18 |
17 |
$2K |
| 99201 |
|
45 |
45 |
$2K |
| 76813 |
|
13 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
126 |
124 |
$1K |
| 90686 |
|
58 |
58 |
$1K |
| 81025 |
|
25 |
25 |
$216.54 |
| 87210 |
|
14 |
14 |
$83.15 |