| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
347 |
335 |
$25K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
50 |
50 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
25 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
24 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
79 |
76 |
$1K |
| 96127 |
|
161 |
161 |
$643.17 |
| 90686 |
|
14 |
14 |
$231.66 |
| 81025 |
|
13 |
13 |
$84.26 |