| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,188 |
2,169 |
$273K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,793 |
1,389 |
$110K |
| 99215 |
Prolong outpt/office vis |
173 |
121 |
$22K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
200 |
173 |
$22K |
| 59025 |
Fetal non-stress test |
528 |
292 |
$18K |
| 81002 |
|
7,122 |
4,849 |
$16K |
| 76830 |
Ultrasound, transvaginal |
96 |
82 |
$6K |
| 76857 |
|
140 |
97 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
2,088 |
1,641 |
$5K |
| 99205 |
Prolong outpt/office vis |
24 |
24 |
$4K |
| 99000 |
|
4,861 |
3,547 |
$3K |
| 81025 |
|
336 |
251 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38 |
30 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
74 |
62 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
16 |
13 |
$988.61 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15 |
13 |
$826.09 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
16 |
12 |
$627.06 |
| 94760 |
|
1,934 |
1,403 |
$358.31 |
| 90674 |
|
21 |
19 |
$322.80 |
| 90688 |
|
12 |
12 |
$188.76 |
| 0503F |
|
13 |
12 |
$0.00 |
| 99024 |
|
15 |
13 |
$0.00 |
| 90687 |
|
13 |
13 |
$0.00 |