| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,557 |
2,175 |
$113K |
| H1000 |
Prenatal care, at-risk assessment |
1,857 |
1,210 |
$102K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
799 |
697 |
$46K |
| 76830 |
Ultrasound, transvaginal |
386 |
364 |
$36K |
| 59430 |
|
182 |
174 |
$31K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
364 |
338 |
$24K |
| 59410 |
|
16 |
16 |
$19K |
| 81025 |
|
1,168 |
1,052 |
$13K |
| 81002 |
|
2,127 |
1,616 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
53 |
46 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
37 |
37 |
$4K |
| 76857 |
|
131 |
122 |
$4K |
| 99385 |
|
44 |
40 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
30 |
28 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
783 |
615 |
$2K |
| 93922 |
|
16 |
16 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
45 |
38 |
$1K |
| 99441 |
|
31 |
31 |
$1K |
| 99442 |
|
15 |
15 |
$1K |
| 99459 |
|
112 |
107 |
$953.59 |
| 76801 |
|
13 |
13 |
$643.47 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$483.96 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
46 |
43 |
$359.13 |
| A4550 |
Surgical trays |
46 |
45 |
$256.52 |
| 95921 |
|
14 |
14 |
$124.26 |
| 96160 |
|
57 |
53 |
$53.55 |
| 83986 |
|
17 |
15 |
$46.40 |
| 93976 |
|
13 |
12 |
$0.00 |