| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,435 |
1,574 |
$113K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
444 |
273 |
$10K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
97 |
67 |
$10K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
253 |
190 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
98 |
78 |
$9K |
| 76801 |
|
132 |
77 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
104 |
79 |
$8K |
| 59025 |
Fetal non-stress test |
367 |
243 |
$6K |
| 85018 |
|
2,079 |
1,545 |
$4K |
| 81002 |
|
1,658 |
1,203 |
$3K |
| 76830 |
Ultrasound, transvaginal |
15 |
12 |
$1K |
| 81025 |
|
73 |
55 |
$382.20 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
28 |
12 |
$363.66 |
| 82950 |
|
70 |
55 |
$321.47 |