| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,019 |
1,938 |
$97K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
345 |
317 |
$14K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
275 |
124 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
200 |
192 |
$9K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
69 |
67 |
$7K |
| 76830 |
Ultrasound, transvaginal |
72 |
65 |
$6K |
| 59430 |
|
46 |
43 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
71 |
69 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
52 |
52 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
13 |
13 |
$1K |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$978.07 |
| 90686 |
|
36 |
36 |
$492.18 |
| 76857 |
|
13 |
13 |
$406.48 |
| 81003 |
|
230 |
144 |
$380.25 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
35 |
35 |
$332.63 |
| 99000 |
|
13 |
13 |
$112.19 |