| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
330 |
241 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70 |
62 |
$8K |
| 76801 |
|
39 |
39 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
41 |
41 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
31 |
30 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$2K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
111 |
87 |
$2K |
| 81002 |
|
32 |
30 |
$88.96 |