| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,739 |
2,521 |
$122K |
| 59025 |
Fetal non-stress test |
2,811 |
1,095 |
$66K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
864 |
830 |
$57K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
485 |
483 |
$30K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
569 |
518 |
$29K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
659 |
500 |
$28K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
440 |
381 |
$26K |
| 76830 |
Ultrasound, transvaginal |
247 |
243 |
$17K |
| 81025 |
|
453 |
439 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
199 |
194 |
$2K |
| 90756 |
|
26 |
26 |
$638.49 |
| 90686 |
|
26 |
26 |
$527.27 |
| 99459 |
|
31 |
31 |
$419.92 |
| 90715 |
|
12 |
12 |
$331.00 |
| 90656 |
|
13 |
13 |
$245.85 |