| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35,101 |
25,250 |
$1.20M |
| 81007 |
|
7,567 |
5,273 |
$180K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,745 |
2,444 |
$126K |
| 76830 |
Ultrasound, transvaginal |
1,143 |
1,086 |
$99K |
| 81000 |
|
19,790 |
13,681 |
$65K |
| 59410 |
|
36 |
36 |
$23K |
| 99205 |
Prolong outpt/office vis |
242 |
223 |
$22K |
| 81002 |
|
5,201 |
3,747 |
$15K |
| 59430 |
|
412 |
386 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
56 |
54 |
$4K |
| 99215 |
Prolong outpt/office vis |
46 |
43 |
$3K |
| 59514 |
|
16 |
16 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
183 |
177 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
13 |
$1K |
| 87800 |
|
25 |
24 |
$777.12 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$677.28 |
| 59025 |
Fetal non-stress test |
19 |
13 |
$665.86 |
| 87480 |
|
27 |
25 |
$357.04 |
| 87660 |
|
27 |
25 |
$349.93 |
| 81025 |
|
13 |
13 |
$82.14 |
| 87510 |
|
27 |
25 |
$41.17 |
| 99459 |
|
697 |
686 |
$0.00 |
| A4550 |
Surgical trays |
95 |
87 |
$0.00 |