| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,331 |
1,227 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
152 |
147 |
$17K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
184 |
150 |
$14K |
| 76830 |
Ultrasound, transvaginal |
140 |
137 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
64 |
64 |
$6K |
| 99459 |
|
228 |
222 |
$5K |
| 81002 |
|
271 |
260 |
$538.85 |
| 90686 |
|
13 |
13 |
$244.58 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$104.03 |
| 96127 |
|
13 |
13 |
$57.33 |
| 81025 |
|
12 |
12 |
$47.73 |