| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,393 |
1,981 |
$147K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
308 |
271 |
$29K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
203 |
188 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
511 |
456 |
$19K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
244 |
193 |
$17K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
115 |
105 |
$12K |
| 81025 |
|
783 |
684 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
183 |
169 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
33 |
26 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
14 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
25 |
24 |
$1K |
| 90658 |
|
104 |
100 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
43 |
37 |
$626.55 |
| 87210 |
|
28 |
26 |
$96.32 |