| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,147 |
2,309 |
$106K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,417 |
1,086 |
$32K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
376 |
319 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
257 |
217 |
$17K |
| 59025 |
Fetal non-stress test |
85 |
48 |
$3K |
| 81025 |
|
751 |
595 |
$3K |
| 99385 |
|
26 |
24 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
30 |
12 |
$1K |
| 90686 |
|
135 |
73 |
$1K |
| 99386 |
|
12 |
12 |
$893.31 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
150 |
89 |
$37.56 |
| 81000 |
|
31 |
24 |
$21.14 |
| 76801 |
|
15 |
12 |
$0.00 |