| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
170 |
157 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
161 |
147 |
$10K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
59 |
48 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
29 |
26 |
$3K |
| 76801 |
|
33 |
29 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$2K |
| 59025 |
Fetal non-stress test |
40 |
25 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
13 |
$1K |
| 98928 |
|
14 |
12 |
$765.83 |
| 98926 |
|
17 |
13 |
$597.39 |
| 99459 |
|
12 |
12 |
$352.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
13 |
$154.22 |