| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,896 |
3,706 |
$182K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,187 |
954 |
$48K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
740 |
706 |
$44K |
| 76818 |
|
453 |
230 |
$36K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
230 |
225 |
$22K |
| 99000 |
|
2,087 |
1,850 |
$21K |
| 81003 |
|
5,954 |
3,689 |
$10K |
| 81025 |
|
1,450 |
1,315 |
$9K |
| 59430 |
|
70 |
67 |
$6K |
| 76801 |
|
55 |
49 |
$3K |
| 59025 |
Fetal non-stress test |
57 |
45 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
169 |
154 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
135 |
127 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
12 |
$843.50 |
| 90674 |
|
27 |
27 |
$751.14 |
| 99218 |
|
14 |
13 |
$705.73 |
| H1010 |
Non-medical family planning education, per session |
27 |
27 |
$309.94 |
| 90715 |
|
13 |
13 |
$304.80 |
| 90756 |
|
14 |
13 |
$297.48 |