| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35,269 |
24,007 |
$2.28M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,326 |
3,944 |
$174K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
941 |
872 |
$57K |
| H1000 |
Prenatal care, at-risk assessment |
361 |
338 |
$26K |
| 81002 |
|
7,724 |
5,346 |
$20K |
| 99385 |
|
257 |
245 |
$19K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
184 |
159 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
633 |
587 |
$9K |
| 59025 |
Fetal non-stress test |
178 |
125 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
60 |
60 |
$4K |
| 76830 |
Ultrasound, transvaginal |
49 |
49 |
$3K |
| 81025 |
|
491 |
462 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
186 |
175 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
177 |
159 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$2K |
| 90674 |
|
26 |
24 |
$705.44 |
| 90686 |
|
30 |
29 |
$548.99 |
| 90715 |
|
13 |
13 |
$444.24 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
238 |
233 |
$0.00 |