| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,039 |
4,334 |
$325K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,902 |
1,439 |
$60K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
517 |
496 |
$55K |
| 59430 |
|
270 |
255 |
$22K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
47 |
38 |
$21K |
| 81002 |
|
7,393 |
4,481 |
$20K |
| 99205 |
Prolong outpt/office vis |
158 |
156 |
$15K |
| 99000 |
|
1,336 |
1,052 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
177 |
165 |
$10K |
| 99215 |
Prolong outpt/office vis |
113 |
70 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
97 |
94 |
$7K |
| 76801 |
|
69 |
64 |
$6K |
| 99441 |
|
172 |
143 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
28 |
$2K |
| 98960 |
|
327 |
233 |
$2K |
| 36410 |
|
155 |
88 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
57 |
53 |
$1K |
| 99354 |
|
21 |
20 |
$594.20 |
| 81025 |
|
95 |
95 |
$551.80 |
| 86703 |
|
40 |
38 |
$350.51 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
18 |
18 |
$251.28 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
18 |
18 |
$111.83 |
| 80055 |
|
12 |
12 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
58 |
58 |
$0.00 |