| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,793 |
1,700 |
$99K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,081 |
617 |
$72K |
| 76830 |
Ultrasound, transvaginal |
392 |
379 |
$33K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
279 |
279 |
$25K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
213 |
171 |
$16K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
160 |
142 |
$14K |
| 59025 |
Fetal non-stress test |
285 |
142 |
$12K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
103 |
102 |
$7K |
| 81002 |
|
2,099 |
2,083 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
41 |
41 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
84 |
83 |
$1K |
| 90686 |
|
75 |
75 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
16 |
$596.40 |
| 87210 |
|
140 |
137 |
$546.72 |
| 76377 |
|
29 |
29 |
$480.06 |
| 81025 |
|
38 |
38 |
$181.32 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$175.68 |
| 83986 |
|
41 |
40 |
$0.00 |
| 99072 |
|
1,317 |
1,244 |
$0.00 |