| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
689 |
580 |
$22K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
87 |
84 |
$6K |
| 76830 |
Ultrasound, transvaginal |
84 |
73 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
31 |
28 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
92 |
83 |
$2K |
| 81025 |
|
232 |
205 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
13 |
$807.84 |
| 81003 |
|
323 |
296 |
$558.43 |
| 87205 |
|
15 |
14 |
$75.66 |
| 85018 |
|
15 |
12 |
$29.12 |
| 0502F |
|
738 |
463 |
$0.00 |