| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,031 |
9,827 |
$1.07M |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,506 |
1,505 |
$153K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
829 |
829 |
$94K |
| 76830 |
Ultrasound, transvaginal |
586 |
578 |
$48K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
563 |
556 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
318 |
315 |
$38K |
| 99385 |
|
320 |
320 |
$33K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
334 |
273 |
$25K |
| 76820 |
|
720 |
507 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
190 |
190 |
$21K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
269 |
264 |
$15K |
| 99051 |
|
4,375 |
3,715 |
$11K |
| 81003 |
|
5,993 |
3,634 |
$9K |
| 93976 |
|
36 |
36 |
$5K |
| 99386 |
|
27 |
27 |
$4K |
| 81002 |
|
1,739 |
1,183 |
$3K |
| 59025 |
Fetal non-stress test |
56 |
42 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
5,940 |
5,009 |
$2K |
| 76801 |
|
15 |
15 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
18 |
13 |
$1K |
| 81025 |
|
231 |
224 |
$832.98 |
| 99429 |
|
30 |
30 |
$252.50 |
| 99072 |
|
316 |
256 |
$0.02 |
| A6413 |
Adhesive bandage, first-aid type, any size, each |
2,644 |
2,254 |
$0.01 |
| 99058 |
|
40 |
40 |
$0.00 |