| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,792 |
1,291 |
$57K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
749 |
635 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
484 |
372 |
$26K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
549 |
387 |
$23K |
| 59025 |
Fetal non-stress test |
843 |
490 |
$18K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
143 |
93 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
94 |
80 |
$7K |
| 76830 |
Ultrasound, transvaginal |
103 |
86 |
$5K |
| 0503F |
|
351 |
243 |
$4K |
| 59430 |
|
97 |
64 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
45 |
27 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
17 |
16 |
$1K |
| 81002 |
|
3,914 |
2,188 |
$716.14 |
| 81025 |
|
242 |
161 |
$647.78 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23 |
17 |
$519.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$149.90 |
| 81003 |
|
69 |
34 |
$48.64 |
| 0502F |
|
3,537 |
1,880 |
$0.00 |
| 3511F |
|
53 |
41 |
$0.00 |
| 3293F |
|
73 |
52 |
$0.00 |
| 3513F |
|
53 |
41 |
$0.00 |
| 3294F |
|
95 |
86 |
$0.00 |
| 3292F |
|
52 |
41 |
$0.00 |
| 0501F |
|
114 |
82 |
$0.00 |
| 3512F |
|
51 |
40 |
$0.00 |