| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,036 |
4,313 |
$331K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,457 |
2,086 |
$81K |
| 59514 |
|
63 |
63 |
$44K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
304 |
303 |
$33K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
54 |
54 |
$33K |
| 76801 |
|
257 |
252 |
$24K |
| 99000 |
|
1,694 |
1,680 |
$18K |
| 59025 |
Fetal non-stress test |
414 |
210 |
$16K |
| 81002 |
|
5,744 |
3,427 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
153 |
151 |
$12K |
| 99215 |
Prolong outpt/office vis |
127 |
124 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
38 |
38 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
31 |
30 |
$3K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$2K |
| 59430 |
|
12 |
12 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$871.12 |