| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,217 |
5,312 |
$247K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
3,618 |
3,350 |
$182K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,384 |
2,083 |
$153K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
751 |
691 |
$41K |
| 81025 |
|
5,297 |
4,624 |
$27K |
| 59025 |
Fetal non-stress test |
765 |
267 |
$21K |
| 99385 |
|
242 |
222 |
$15K |
| 76801 |
|
169 |
140 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
41 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
240 |
214 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
48 |
37 |
$3K |
| 90688 |
|
255 |
172 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
100 |
78 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
14 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
17 |
14 |
$1K |
| 90686 |
|
42 |
42 |
$841.73 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$671.09 |
| 99442 |
|
13 |
12 |
$465.36 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
43 |
40 |
$166.87 |
| 82270 |
|
67 |
59 |
$161.29 |
| 81002 |
|
401 |
351 |
$126.89 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
312 |
247 |
$25.04 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$0.00 |