| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,109 |
1,088 |
$54K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
565 |
565 |
$49K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
141 |
141 |
$13K |
| 59025 |
Fetal non-stress test |
140 |
52 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
129 |
121 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
57 |
55 |
$2K |
| 76830 |
Ultrasound, transvaginal |
65 |
65 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40 |
40 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
14 |
$1K |
| 90674 |
|
44 |
43 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
26 |
26 |
$907.96 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
53 |
50 |
$515.93 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15 |
14 |
$379.80 |
| 87210 |
|
44 |
44 |
$180.60 |