| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,643 |
3,444 |
$217K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
746 |
713 |
$74K |
| 59025 |
Fetal non-stress test |
1,539 |
1,170 |
$56K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,353 |
1,347 |
$44K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,350 |
1,345 |
$44K |
| S9999 |
Sales tax |
1,049 |
786 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
218 |
215 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
146 |
144 |
$12K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
75 |
74 |
$11K |
| 81025 |
|
1,143 |
1,115 |
$9K |
| 76801 |
|
46 |
45 |
$7K |
| 87660 |
|
341 |
335 |
$6K |
| 91122 |
|
31 |
12 |
$6K |
| 87510 |
|
322 |
318 |
$6K |
| 87480 |
|
321 |
317 |
$6K |
| 51784 |
|
31 |
12 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$2K |
| 81002 |
|
590 |
570 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$931.76 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
14 |
14 |
$824.10 |
| 81003 |
|
89 |
89 |
$147.60 |