| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,860 |
5,101 |
$218K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,664 |
1,723 |
$122K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
334 |
318 |
$19K |
| 81002 |
|
6,068 |
3,596 |
$14K |
| 76830 |
Ultrasound, transvaginal |
154 |
151 |
$14K |
| 59430 |
|
136 |
119 |
$12K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
142 |
130 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
137 |
134 |
$9K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
62 |
60 |
$8K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
124 |
82 |
$7K |
| 81025 |
|
387 |
368 |
$2K |
| 59025 |
Fetal non-stress test |
53 |
27 |
$1K |
| 76813 |
|
13 |
12 |
$1K |
| 76801 |
|
13 |
12 |
$994.44 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
13 |
$962.90 |
| 81003 |
|
590 |
543 |
$890.82 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$708.15 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
75 |
72 |
$658.04 |
| 90674 |
|
26 |
26 |
$596.64 |
| 90686 |
|
14 |
14 |
$198.40 |
| 99051 |
|
35 |
33 |
$180.73 |
| 0502F |
|
722 |
434 |
$0.00 |