| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,511 |
2,049 |
$88K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,347 |
1,102 |
$63K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
29 |
27 |
$37K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
316 |
299 |
$20K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
290 |
239 |
$14K |
| 99459 |
|
558 |
507 |
$7K |
| 59410 |
|
14 |
14 |
$7K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
121 |
57 |
$5K |
| 0503F |
|
84 |
65 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
54 |
52 |
$4K |
| 76801 |
|
76 |
64 |
$4K |
| 96160 |
|
273 |
194 |
$3K |
| 0500F |
|
129 |
115 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
43 |
43 |
$3K |
| 59430 |
|
49 |
41 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
20 |
13 |
$1K |
| 59025 |
Fetal non-stress test |
32 |
13 |
$980.92 |
| 90715 |
|
18 |
14 |
$739.16 |
| 81025 |
|
184 |
150 |
$606.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
54 |
41 |
$600.48 |