| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
397 |
365 |
$17K |
| 76830 |
Ultrasound, transvaginal |
179 |
177 |
$17K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
165 |
163 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
211 |
198 |
$13K |
| 59426 |
|
21 |
19 |
$11K |
| 59025 |
Fetal non-stress test |
144 |
91 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
215 |
207 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
62 |
61 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
30 |
30 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
55 |
39 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
14 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
15 |
13 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
20 |
13 |
$995.70 |
| 81025 |
|
164 |
161 |
$786.78 |
| 81002 |
|
330 |
235 |
$213.42 |
| A4550 |
Surgical trays |
148 |
124 |
$0.00 |
| 99000 |
|
340 |
327 |
$0.00 |
| 0500F |
|
17 |
17 |
$0.00 |
| 0503F |
|
12 |
12 |
$0.00 |