| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,151 |
1,831 |
$83K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
708 |
645 |
$54K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
711 |
626 |
$42K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
284 |
262 |
$23K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
211 |
193 |
$19K |
| 76830 |
Ultrasound, transvaginal |
159 |
139 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
162 |
144 |
$10K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
130 |
83 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
191 |
163 |
$5K |
| 99459 |
|
342 |
313 |
$5K |
| 0503F |
|
534 |
440 |
$3K |
| 76801 |
|
30 |
25 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
24 |
$1K |
| 96127 |
|
335 |
315 |
$1K |
| 87210 |
|
327 |
268 |
$1K |
| 81002 |
|
298 |
245 |
$694.31 |
| 0502F |
|
8,138 |
4,459 |
$590.00 |
| 90756 |
|
25 |
14 |
$567.78 |
| 81025 |
|
43 |
39 |
$206.62 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
14 |
$141.91 |
| 83986 |
|
55 |
38 |
$19.90 |
| 59430 |
|
39 |
32 |
$0.00 |