| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,867 |
5,234 |
$598K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,427 |
1,191 |
$157K |
| 76830 |
Ultrasound, transvaginal |
1,171 |
1,091 |
$106K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,186 |
1,103 |
$89K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
742 |
677 |
$79K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
4,366 |
2,222 |
$39K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
249 |
187 |
$12K |
| 99219 |
|
98 |
82 |
$11K |
| 59514 |
|
16 |
15 |
$5K |
| H1000 |
Prenatal care, at-risk assessment |
178 |
118 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
25 |
$4K |
| 59025 |
Fetal non-stress test |
143 |
109 |
$3K |
| 81002 |
|
1,048 |
574 |
$2K |
| 59430 |
|
16 |
13 |
$1K |
| 0503F |
|
12 |
12 |
$190.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$187.52 |
| 0502F |
|
23 |
12 |
$0.00 |