| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,765 |
3,231 |
$133K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
618 |
473 |
$27K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
322 |
250 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
267 |
229 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
106 |
90 |
$8K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
119 |
60 |
$6K |
| 0503F |
|
364 |
269 |
$5K |
| 85018 |
|
1,597 |
1,467 |
$3K |
| 0500F |
|
374 |
256 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
29 |
26 |
$2K |
| 81025 |
|
238 |
210 |
$1K |
| 76830 |
Ultrasound, transvaginal |
15 |
12 |
$941.46 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
26 |
$790.58 |
| 90674 |
|
41 |
29 |
$700.72 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
13 |
$644.48 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
44 |
$375.48 |
| 0502F |
|
343 |
268 |
$370.00 |
| 82950 |
|
95 |
88 |
$367.58 |
| 96160 |
|
20 |
12 |
$250.18 |
| 0501F |
|
127 |
92 |
$90.00 |
| 80305 |
|
14 |
14 |
$73.96 |
| 3292F |
|
54 |
38 |
$0.00 |
| 3754F |
|
54 |
38 |
$0.00 |
| 3294F |
|
52 |
37 |
$0.00 |