| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,601 |
4,562 |
$162K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,252 |
1,063 |
$56K |
| 59025 |
Fetal non-stress test |
2,234 |
1,401 |
$44K |
| 81003 |
|
23,146 |
18,007 |
$37K |
| 0503F |
|
488 |
383 |
$25K |
| 76830 |
Ultrasound, transvaginal |
363 |
283 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
129 |
117 |
$9K |
| 59430 |
|
477 |
371 |
$6K |
| 99459 |
|
181 |
167 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
42 |
30 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
342 |
296 |
$2K |
| 90686 |
|
133 |
112 |
$2K |
| 90715 |
|
51 |
40 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
35 |
28 |
$1K |
| 0500F |
|
38 |
25 |
$615.00 |
| 81025 |
|
70 |
58 |
$399.74 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$331.17 |
| 90656 |
|
18 |
18 |
$319.70 |
| 36415 |
Collection of venous blood by venipuncture |
79 |
63 |
$171.85 |
| 0501F |
|
72 |
55 |
$0.00 |
| 0502F |
|
47 |
43 |
$0.00 |