| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,851 |
2,377 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,954 |
1,238 |
$67K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
707 |
519 |
$45K |
| 76801 |
|
183 |
153 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
542 |
397 |
$11K |
| 81002 |
|
5,405 |
2,981 |
$11K |
| 76830 |
Ultrasound, transvaginal |
115 |
108 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
170 |
155 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
213 |
190 |
$10K |
| 59430 |
|
102 |
91 |
$9K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
121 |
83 |
$7K |
| 76818 |
|
58 |
29 |
$5K |
| 81025 |
|
579 |
515 |
$3K |
| 59025 |
Fetal non-stress test |
55 |
25 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
13 |
12 |
$780.76 |
| 90674 |
|
20 |
17 |
$405.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
37 |
$377.94 |
| 81000 |
|
149 |
104 |
$324.09 |
| 82947 |
|
22 |
14 |
$52.20 |
| 82962 |
|
99 |
38 |
$0.00 |