| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,794 |
3,495 |
$201K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,416 |
2,397 |
$178K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
535 |
490 |
$29K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
329 |
295 |
$23K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
488 |
311 |
$19K |
| 99205 |
Prolong outpt/office vis |
121 |
94 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
155 |
113 |
$6K |
| 81025 |
|
1,150 |
986 |
$6K |
| 59025 |
Fetal non-stress test |
237 |
129 |
$4K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
69 |
40 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
94 |
83 |
$2K |
| 87210 |
|
580 |
409 |
$2K |
| 81000 |
|
344 |
232 |
$546.91 |
| 90686 |
|
16 |
12 |
$190.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
137 |
97 |
$190.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$132.30 |
| 90658 |
|
17 |
13 |
$131.20 |
| 99000 |
|
1,697 |
1,465 |
$0.00 |