| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,625 |
1,483 |
$90K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,244 |
829 |
$87K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
795 |
558 |
$51K |
| 81025 |
|
5,149 |
3,316 |
$24K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,861 |
1,242 |
$21K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
432 |
334 |
$20K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
227 |
212 |
$10K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
42 |
37 |
$4K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
31 |
24 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
26 |
$3K |
| 76830 |
Ultrasound, transvaginal |
24 |
12 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$947.65 |
| 81002 |
|
561 |
333 |
$894.67 |