| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,328 |
1,259 |
$17K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
452 |
450 |
$14K |
| 76830 |
Ultrasound, transvaginal |
453 |
451 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
333 |
333 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
432 |
418 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
135 |
135 |
$4K |
| 88141 |
|
797 |
793 |
$2K |
| 59430 |
|
14 |
14 |
$1K |
| 76801 |
|
26 |
26 |
$705.78 |
| 81025 |
|
470 |
460 |
$571.20 |
| 58100 |
|
14 |
14 |
$205.20 |
| 59425 |
|
15 |
12 |
$120.96 |
| 57410 |
|
19 |
18 |
$112.49 |
| 99223 |
Prolong inpt eval add15 m |
13 |
13 |
$80.10 |
| A4550 |
Surgical trays |
187 |
186 |
$75.00 |
| 99000 |
|
35 |
35 |
$0.00 |
| 0503F |
|
13 |
13 |
$0.00 |