| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,858 |
18,088 |
$1.65M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,393 |
1,261 |
$158K |
| 76830 |
Ultrasound, transvaginal |
1,374 |
1,283 |
$117K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
914 |
823 |
$79K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
540 |
527 |
$65K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
698 |
458 |
$49K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
222 |
203 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
244 |
222 |
$24K |
| 96127 |
|
4,240 |
3,016 |
$20K |
| 76801 |
|
192 |
164 |
$15K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,514 |
876 |
$10K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
369 |
303 |
$7K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
431 |
345 |
$7K |
| 87481 |
|
363 |
295 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
405 |
332 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
405 |
332 |
$7K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
42 |
41 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
73 |
68 |
$4K |
| 59430 |
|
29 |
26 |
$4K |
| 99459 |
|
113 |
111 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$3K |
| 90715 |
|
74 |
73 |
$3K |
| 90674 |
|
74 |
71 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
19 |
16 |
$1K |
| 0503F |
|
54 |
53 |
$950.00 |
| 96161 |
|
317 |
305 |
$792.22 |
| 36415 |
Collection of venous blood by venipuncture |
412 |
359 |
$755.09 |
| 81025 |
|
204 |
171 |
$588.79 |
| 81002 |
|
224 |
194 |
$548.46 |
| 81003 |
|
1,123 |
966 |
$498.05 |
| H1000 |
Prenatal care, at-risk assessment |
14 |
14 |
$480.00 |
| 99000 |
|
967 |
796 |
$177.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
18 |
$64.16 |
| 81513 |
|
139 |
101 |
$0.00 |