| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
594 |
572 |
$67K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
669 |
614 |
$50K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
646 |
533 |
$30K |
| 31231 |
|
132 |
130 |
$25K |
| 92557 |
|
671 |
625 |
$22K |
| 92567 |
|
1,215 |
1,135 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
339 |
315 |
$15K |
| 70450 |
Computed tomography, head or brain; without contrast material |
746 |
582 |
$14K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
217 |
198 |
$12K |
| 92587 |
|
651 |
609 |
$12K |
| 71045 |
Radiologic examination, chest; single view |
2,164 |
1,597 |
$10K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
198 |
149 |
$9K |
| 92579 |
|
147 |
135 |
$6K |
| 92555 |
|
147 |
136 |
$4K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
12 |
12 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
116 |
77 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
99 |
92 |
$2K |
| 92504 |
|
85 |
78 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
190 |
149 |
$2K |
| 93975 |
|
35 |
32 |
$2K |
| 85610 |
|
35 |
29 |
$734.86 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
20 |
19 |
$571.55 |
| 76830 |
Ultrasound, transvaginal |
17 |
16 |
$478.36 |
| 74018 |
|
59 |
53 |
$461.36 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
15 |
$454.95 |
| 73630 |
|
61 |
54 |
$396.51 |
| 96127 |
|
12 |
12 |
$395.34 |
| 73130 |
|
55 |
45 |
$354.37 |
| 71250 |
|
60 |
41 |
$268.36 |
| 73610 |
|
33 |
28 |
$225.66 |
| 73560 |
|
34 |
28 |
$221.53 |
| 73110 |
|
33 |
31 |
$190.02 |
| 73030 |
|
33 |
30 |
$188.82 |
| 92550 |
|
41 |
39 |
$0.00 |