| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,641 |
4,438 |
$340K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
188 |
132 |
$222K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,474 |
992 |
$115K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,433 |
1,041 |
$101K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
945 |
659 |
$72K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
631 |
481 |
$66K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
887 |
522 |
$54K |
| 76830 |
Ultrasound, transvaginal |
551 |
354 |
$37K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
223 |
152 |
$21K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
525 |
417 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
397 |
322 |
$15K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
104 |
81 |
$11K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
62 |
27 |
$5K |
| 99199 |
Unlisted special service, procedure or report |
1,399 |
1,393 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
36 |
36 |
$3K |
| 81025 |
|
327 |
248 |
$2K |
| 87210 |
|
546 |
317 |
$1K |
| 99385 |
|
23 |
12 |
$651.55 |
| 99000 |
|
580 |
421 |
$0.00 |