| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
2,027 |
1,188 |
$118K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,395 |
4,054 |
$113K |
| G9012 |
Other specified case management service not elsewhere classified |
255 |
179 |
$80K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,358 |
1,353 |
$79K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,005 |
957 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
270 |
269 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
772 |
740 |
$15K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
182 |
90 |
$11K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
737 |
406 |
$6K |
| 81002 |
|
2,675 |
1,637 |
$6K |
| 99205 |
Prolong outpt/office vis |
15 |
15 |
$5K |
| Z1034 |
|
86 |
38 |
$5K |
| 99215 |
Prolong outpt/office vis |
25 |
24 |
$3K |
| 99000 |
|
386 |
378 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
27 |
27 |
$1K |
| 59430 |
|
13 |
13 |
$1K |
| 57454 |
|
13 |
13 |
$1K |
| 96127 |
|
32 |
32 |
$243.02 |
| 81025 |
|
89 |
88 |
$234.40 |
| 99072 |
|
84 |
69 |
$195.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
17 |
17 |
$141.93 |
| A4402 |
Lubricant, per ounce |
361 |
358 |
$105.99 |
| 96160 |
|
18 |
16 |
$93.60 |