| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,398 |
6,692 |
$173K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
801 |
778 |
$70K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
711 |
696 |
$61K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
545 |
545 |
$47K |
| 76801 |
|
348 |
323 |
$34K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
217 |
216 |
$29K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
350 |
341 |
$21K |
| 76830 |
Ultrasound, transvaginal |
351 |
340 |
$20K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
194 |
194 |
$17K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
63 |
40 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
68 |
68 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
92 |
90 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
176 |
156 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
3,489 |
3,239 |
$1K |
| 81002 |
|
549 |
548 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
53 |
53 |
$727.48 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
39 |
39 |
$567.30 |
| 59025 |
Fetal non-stress test |
12 |
12 |
$522.73 |
| 87210 |
|
130 |
127 |
$478.25 |
| 90686 |
|
16 |
16 |
$307.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
43 |
$174.35 |
| 82270 |
|
13 |
13 |
$40.89 |
| 81025 |
|
14 |
14 |
$23.80 |
| 81003 |
|
14 |
14 |
$20.44 |
| 3078F |
|
31 |
30 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
14 |
14 |
$0.00 |
| 3075F |
|
19 |
18 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
20 |
17 |
$0.00 |