| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,670 |
6,859 |
$471K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
515 |
421 |
$45K |
| 99199 |
Unlisted special service, procedure or report |
11,897 |
11,342 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
481 |
364 |
$34K |
| 81003 |
|
6,997 |
5,572 |
$17K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
105 |
100 |
$11K |
| 99385 |
|
89 |
79 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
100 |
89 |
$7K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
168 |
141 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
91 |
81 |
$6K |
| 85018 |
|
2,538 |
2,140 |
$6K |
| 81025 |
|
996 |
709 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
2,208 |
1,815 |
$5K |
| 59025 |
Fetal non-stress test |
183 |
120 |
$4K |
| 76801 |
|
33 |
28 |
$3K |
| 87210 |
|
765 |
617 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
35 |
29 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
162 |
137 |
$2K |
| 76830 |
Ultrasound, transvaginal |
28 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
182 |
163 |
$2K |
| 90686 |
|
112 |
98 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
34 |
26 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
13 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$949.12 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
13 |
$623.18 |
| 90715 |
|
16 |
13 |
$481.32 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
17 |
12 |
$272.04 |
| 96127 |
|
12 |
12 |
$39.00 |