| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,147 |
5,029 |
$320K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,451 |
1,429 |
$141K |
| 59025 |
Fetal non-stress test |
4,117 |
3,405 |
$107K |
| 99080 |
|
378 |
378 |
$8K |
| 99233 |
Prolong inpt eval add15 m |
91 |
86 |
$7K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
90 |
88 |
$5K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39 |
39 |
$4K |
| 81025 |
|
690 |
686 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
64 |
64 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
184 |
180 |
$2K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
43 |
36 |
$1K |
| 99221 |
|
13 |
12 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 99459 |
|
42 |
42 |
$793.64 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
29 |
28 |
$485.52 |
| 90686 |
|
25 |
25 |
$464.34 |
| 76801 |
|
13 |
13 |
$320.23 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
24 |
$267.34 |
| 87210 |
|
53 |
52 |
$242.14 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
15 |
15 |
$173.32 |
| 96127 |
|
12 |
12 |
$47.52 |
| 81002 |
|
15 |
13 |
$42.95 |