| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,026 |
9,487 |
$627K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
981 |
981 |
$86K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
860 |
828 |
$71K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,239 |
3,223 |
$66K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,238 |
3,222 |
$66K |
| 87480 |
|
5,019 |
4,961 |
$64K |
| 87510 |
|
5,011 |
4,954 |
$64K |
| 87660 |
|
5,013 |
4,956 |
$64K |
| 76830 |
Ultrasound, transvaginal |
806 |
792 |
$55K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
153 |
110 |
$11K |
| 76801 |
|
95 |
94 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
95 |
95 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
71 |
71 |
$7K |
| 99459 |
|
301 |
300 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
44 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
738 |
730 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
29 |
25 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
3,973 |
3,680 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
713 |
712 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15 |
13 |
$1K |
| 59025 |
Fetal non-stress test |
27 |
24 |
$847.70 |
| 90674 |
|
17 |
17 |
$458.39 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
43 |
$323.91 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
12 |
$263.48 |
| 84702 |
|
17 |
12 |
$171.88 |
| 84443 |
Thyroid stimulating hormone (TSH) |
14 |
14 |
$126.81 |
| 84439 |
|
14 |
14 |
$104.76 |
| 81025 |
|
12 |
12 |
$51.60 |
| 81002 |
|
12 |
12 |
$19.72 |