| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
650 |
570 |
$19K |
| 99215 |
Prolong outpt/office vis |
141 |
134 |
$15K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
288 |
261 |
$12K |
| 76801 |
|
93 |
82 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
76 |
65 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
53 |
51 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
64 |
$3K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
15 |
14 |
$2K |
| 59025 |
Fetal non-stress test |
59 |
51 |
$2K |
| 86580 |
|
231 |
207 |
$1K |
| 81025 |
|
103 |
85 |
$644.62 |
| 90686 |
|
74 |
44 |
$612.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
66 |
44 |
$440.90 |
| 81000 |
|
102 |
93 |
$328.44 |
| 87210 |
|
36 |
28 |
$121.56 |
| 81002 |
|
24 |
24 |
$66.15 |