| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,446 |
3,094 |
$123K |
| 59425 |
|
1,446 |
951 |
$87K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
714 |
703 |
$48K |
| 76830 |
Ultrasound, transvaginal |
699 |
685 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
876 |
770 |
$26K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
371 |
281 |
$23K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
188 |
188 |
$14K |
| 99406 |
|
531 |
471 |
$5K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
44 |
39 |
$4K |
| 99215 |
Prolong outpt/office vis |
86 |
85 |
$3K |
| 81025 |
|
933 |
878 |
$3K |
| 97803 |
|
298 |
217 |
$3K |
| 99401 |
|
292 |
216 |
$2K |
| 81002 |
|
1,015 |
831 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
16 |
15 |
$2K |
| 99205 |
Prolong outpt/office vis |
13 |
13 |
$851.00 |