| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
645 |
624 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
149 |
146 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
79 |
79 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
50 |
47 |
$3K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
94 |
80 |
$2K |
| 76801 |
|
14 |
14 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
51 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
22 |
12 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$428.40 |
| 94010 |
|
16 |
16 |
$358.68 |
| 90680 |
|
16 |
16 |
$0.00 |
| 90723 |
|
16 |
16 |
$0.00 |
| 90647 |
|
32 |
32 |
$0.00 |
| 90670 |
|
31 |
31 |
$0.00 |