| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,868 |
5,955 |
$374K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,144 |
1,011 |
$64K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,684 |
1,481 |
$56K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,672 |
1,479 |
$56K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
54 |
54 |
$31K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
574 |
485 |
$28K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
317 |
288 |
$23K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
376 |
326 |
$19K |
| 87660 |
|
1,097 |
906 |
$18K |
| 87480 |
|
1,152 |
906 |
$17K |
| 87510 |
|
1,155 |
905 |
$17K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,128 |
1,879 |
$14K |
| 59514 |
|
28 |
28 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
527 |
467 |
$12K |
| 76801 |
|
146 |
135 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
160 |
131 |
$8K |
| 59430 |
|
52 |
51 |
$5K |
| 81025 |
|
868 |
757 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
380 |
318 |
$4K |
| 76813 |
|
43 |
42 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
521 |
461 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
28 |
28 |
$2K |
| 84702 |
|
155 |
115 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
29 |
26 |
$2K |
| 84144 |
|
76 |
65 |
$1K |
| 59025 |
Fetal non-stress test |
68 |
43 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$449.40 |
| 90674 |
|
15 |
15 |
$300.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
15 |
$205.80 |