| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,524 |
3,404 |
$207K |
| 0502F |
|
1,902 |
1,041 |
$43K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
232 |
217 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
202 |
158 |
$12K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
139 |
137 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
72 |
60 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
28 |
12 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$874.44 |
| 81025 |
|
139 |
135 |
$759.31 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$725.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
39 |
39 |
$437.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
17 |
$249.90 |
| 90656 |
|
13 |
13 |
$237.24 |
| 81003 |
|
38 |
31 |
$17.92 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
13 |
$0.00 |