| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,700 |
10,654 |
$834K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,167 |
6,079 |
$690K |
| 81002 |
|
14,017 |
11,054 |
$46K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
438 |
433 |
$44K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
462 |
407 |
$38K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
323 |
311 |
$36K |
| 81025 |
|
3,854 |
3,639 |
$28K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
27 |
24 |
$28K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
309 |
295 |
$28K |
| 76830 |
Ultrasound, transvaginal |
272 |
269 |
$26K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
494 |
481 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
140 |
134 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
72 |
64 |
$9K |
| 59430 |
|
54 |
53 |
$9K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
123 |
74 |
$8K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
343 |
325 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
324 |
286 |
$5K |
| 59025 |
Fetal non-stress test |
133 |
88 |
$5K |
| A4550 |
Surgical trays |
603 |
570 |
$3K |
| 99080 |
|
12 |
12 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
581 |
537 |
$2K |
| 90715 |
|
57 |
54 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$2K |
| 90756 |
|
93 |
73 |
$2K |
| 76801 |
|
14 |
14 |
$2K |
| 90674 |
|
59 |
57 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$749.49 |
| 87210 |
|
64 |
62 |
$305.55 |
| 96160 |
|
13 |
13 |
$137.18 |
| 94760 |
|
17 |
15 |
$32.42 |
| 99459 |
|
33 |
31 |
$0.00 |