| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,156 |
3,879 |
$221K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
692 |
643 |
$48K |
| 76830 |
Ultrasound, transvaginal |
453 |
432 |
$41K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
228 |
211 |
$21K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
29 |
26 |
$15K |
| 76857 |
|
431 |
409 |
$14K |
| 81003 |
|
4,068 |
2,847 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
103 |
100 |
$6K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
51 |
42 |
$6K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
73 |
73 |
$5K |
| 76801 |
|
49 |
40 |
$4K |
| 99205 |
Prolong outpt/office vis |
61 |
46 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
52 |
44 |
$3K |
| 81025 |
|
492 |
456 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
28 |
27 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75 |
71 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
57 |
49 |
$2K |
| 99385 |
|
27 |
27 |
$1K |
| 99233 |
Prolong inpt eval add15 m |
15 |
13 |
$679.52 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
47 |
41 |
$24.50 |
| 87070 |
|
24 |
23 |
$21.72 |
| 87102 |
|
21 |
20 |
$21.18 |
| A4559 |
Coupling gel or paste, for use with ultrasound device, per oz |
639 |
608 |
$0.00 |