| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
690 |
570 |
$39K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
148 |
80 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
181 |
111 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
45 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
25 |
$2K |
| 90686 |
|
31 |
28 |
$701.37 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
117 |
106 |
$567.95 |
| 90674 |
|
13 |
13 |
$481.75 |
| 81025 |
|
43 |
40 |
$163.59 |