| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,174 |
3,957 |
$198K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,853 |
1,518 |
$75K |
| 76818 |
|
572 |
296 |
$48K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
610 |
557 |
$32K |
| 76801 |
|
364 |
312 |
$32K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
315 |
304 |
$30K |
| 99000 |
|
2,753 |
2,405 |
$27K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
238 |
231 |
$19K |
| 59514 |
|
25 |
25 |
$17K |
| 81025 |
|
2,546 |
2,276 |
$13K |
| 81003 |
|
6,300 |
3,968 |
$8K |
| 59430 |
|
61 |
58 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
309 |
274 |
$4K |
| H1010 |
Non-medical family planning education, per session |
311 |
305 |
$4K |
| 90715 |
|
71 |
70 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
281 |
255 |
$3K |
| 99234 |
|
12 |
12 |
$1K |
| 99218 |
|
27 |
26 |
$1K |
| 59025 |
Fetal non-stress test |
37 |
26 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
13 |
$1K |
| 99078 |
|
26 |
26 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 90674 |
|
36 |
34 |
$806.05 |
| 90756 |
|
37 |
37 |
$781.05 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$684.31 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17 |
15 |
$0.00 |
| 0503F |
|
17 |
15 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
18 |
13 |
$0.00 |