| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,449 |
4,270 |
$424K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
787 |
719 |
$32K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
53 |
48 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$827.43 |
| 90756 |
|
13 |
12 |
$278.04 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
12 |
$238.02 |