| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,240 |
3,165 |
$251K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,434 |
3,340 |
$199K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,821 |
1,645 |
$95K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,624 |
1,271 |
$58K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
816 |
747 |
$44K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
806 |
603 |
$42K |
| 76820 |
|
1,887 |
1,467 |
$41K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
485 |
485 |
$40K |
| 76801 |
|
756 |
683 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
445 |
445 |
$31K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
474 |
200 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
384 |
368 |
$25K |
| 99215 |
Prolong outpt/office vis |
165 |
154 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
209 |
208 |
$12K |
| 76830 |
Ultrasound, transvaginal |
306 |
305 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
216 |
184 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
43 |
37 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
28 |
13 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
252 |
252 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
13 |
13 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
42 |
42 |
$1K |
| 93970 |
|
42 |
42 |
$915.94 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$826.58 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
25 |
$788.05 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
30 |
30 |
$713.55 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$644.76 |
| 76818 |
|
13 |
13 |
$520.12 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12 |
12 |
$442.99 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$174.12 |
| 3074F |
|
118 |
118 |
$0.00 |
| 3044F |
|
28 |
28 |
$0.00 |
| 3078F |
|
155 |
154 |
$0.00 |