| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,758 |
1,982 |
$124K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,163 |
2,239 |
$101K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
254 |
245 |
$21K |
| 81002 |
|
5,173 |
3,074 |
$12K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
119 |
112 |
$12K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
86 |
70 |
$6K |
| 81025 |
|
544 |
515 |
$3K |
| 59430 |
|
24 |
24 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$862.29 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$824.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$120.72 |
| 90688 |
|
15 |
15 |
$50.40 |