| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,363 |
3,009 |
$145K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
897 |
824 |
$71K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,807 |
1,562 |
$52K |
| 59025 |
Fetal non-stress test |
1,712 |
1,352 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
586 |
514 |
$37K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
336 |
285 |
$23K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
204 |
183 |
$20K |
| 81003 |
|
6,796 |
6,076 |
$13K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
134 |
128 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
186 |
150 |
$10K |
| 81025 |
|
1,317 |
1,134 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
102 |
84 |
$7K |
| 54150 |
|
30 |
26 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
87 |
80 |
$5K |
| 99385 |
|
46 |
44 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
82 |
38 |
$4K |
| 87210 |
|
682 |
611 |
$3K |
| 99215 |
Prolong outpt/office vis |
26 |
24 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
29 |
26 |
$2K |
| 76830 |
Ultrasound, transvaginal |
17 |
12 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
18 |
14 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
49 |
49 |
$797.25 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
67 |
$631.68 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
27 |
$524.00 |
| 90715 |
|
16 |
12 |
$510.98 |
| 90686 |
|
12 |
12 |
$245.86 |
| 0500F |
|
107 |
107 |
$20.15 |
| 0503F |
|
49 |
49 |
$0.06 |
| 0502F |
|
8,576 |
7,605 |
$0.00 |