| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,455 |
4,548 |
$225K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,545 |
1,306 |
$120K |
| 59426 |
|
240 |
170 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
431 |
401 |
$30K |
| 59025 |
Fetal non-stress test |
993 |
561 |
$24K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
125 |
108 |
$12K |
| 76830 |
Ultrasound, transvaginal |
83 |
78 |
$7K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
74 |
73 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
42 |
37 |
$3K |
| 90715 |
|
68 |
66 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
49 |
28 |
$2K |
| 99072 |
|
343 |
303 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
34 |
29 |
$773.92 |
| G9001 |
Coordinated care fee, initial rate |
27 |
26 |
$650.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
69 |
67 |
$604.50 |
| 81025 |
|
91 |
84 |
$540.38 |
| 96127 |
|
61 |
52 |
$293.12 |
| 87210 |
|
13 |
12 |
$52.03 |
| 81003 |
|
24 |
24 |
$47.06 |