| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,023 |
5,299 |
$258K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,841 |
2,779 |
$174K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
400 |
380 |
$40K |
| 81002 |
|
8,578 |
5,194 |
$24K |
| 81025 |
|
2,019 |
1,893 |
$13K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
138 |
116 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
168 |
168 |
$11K |
| 99205 |
Prolong outpt/office vis |
81 |
80 |
$8K |
| 76830 |
Ultrasound, transvaginal |
44 |
44 |
$4K |
| 81003 |
|
1,798 |
1,461 |
$3K |
| 59430 |
|
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
55 |
51 |
$399.84 |
| 90715 |
|
12 |
12 |
$378.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$133.17 |
| 87210 |
|
25 |
24 |
$112.47 |