| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,994 |
2,171 |
$334K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,432 |
2,816 |
$268K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,202 |
776 |
$92K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
491 |
468 |
$54K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
759 |
510 |
$52K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
758 |
639 |
$36K |
| 99215 |
Prolong outpt/office vis |
223 |
209 |
$32K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,315 |
865 |
$17K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
2,007 |
1,167 |
$17K |
| 81001 |
|
5,333 |
3,530 |
$12K |
| 99385 |
|
40 |
38 |
$5K |
| 87210 |
|
1,314 |
1,188 |
$5K |
| 76813 |
|
41 |
37 |
$4K |
| 81025 |
|
599 |
539 |
$3K |
| 99205 |
Prolong outpt/office vis |
18 |
13 |
$3K |
| 99386 |
|
14 |
12 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
50 |
43 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
77 |
68 |
$1K |
| 76830 |
Ultrasound, transvaginal |
18 |
15 |
$1K |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
101 |
98 |
$884.35 |
| 90715 |
|
12 |
12 |
$433.92 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
176 |
167 |
$325.25 |
| 81003 |
|
28 |
23 |
$39.60 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
15 |
$7.56 |