| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,106 |
3,388 |
$149K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,713 |
1,616 |
$130K |
| 76830 |
Ultrasound, transvaginal |
1,745 |
1,292 |
$114K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
399 |
379 |
$36K |
| 81025 |
|
4,668 |
3,805 |
$24K |
| 0503F |
|
485 |
425 |
$21K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
13 |
12 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
158 |
135 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
85 |
81 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
92 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
401 |
355 |
$6K |
| 0500F |
|
612 |
411 |
$6K |
| 54150 |
|
18 |
17 |
$3K |
| 99215 |
Prolong outpt/office vis |
27 |
24 |
$2K |
| 90756 |
|
42 |
38 |
$860.15 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
38 |
$529.75 |
| 59430 |
|
420 |
368 |
$348.70 |
| 81002 |
|
12 |
12 |
$33.65 |
| 0502F |
|
9,976 |
5,940 |
$10.00 |
| 0501F |
|
337 |
335 |
$0.00 |