| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
1,323 |
594 |
$112K |
| 59410 |
|
158 |
138 |
$110K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,288 |
1,833 |
$110K |
| 59425 |
|
1,072 |
695 |
$88K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
700 |
566 |
$48K |
| 59515 |
|
60 |
48 |
$42K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
356 |
313 |
$24K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
250 |
207 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
240 |
216 |
$20K |
| 76818 |
|
266 |
118 |
$20K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
169 |
147 |
$13K |
| 81025 |
|
1,212 |
980 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
68 |
55 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
302 |
250 |
$4K |
| 81002 |
|
3,605 |
2,242 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70 |
50 |
$2K |
| 90461 |
|
237 |
206 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
90 |
82 |
$1K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
77 |
67 |
$1K |
| 59430 |
|
124 |
119 |
$454.86 |
| 82947 |
|
65 |
24 |
$83.44 |
| 90670 |
|
188 |
167 |
$0.00 |
| 90698 |
|
132 |
121 |
$0.00 |
| 90744 |
|
75 |
67 |
$0.00 |
| 90680 |
|
122 |
111 |
$0.00 |