| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,325 |
3,509 |
$371K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,685 |
5,214 |
$371K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,771 |
1,607 |
$199K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,561 |
1,399 |
$118K |
| 76801 |
|
360 |
276 |
$36K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
184 |
144 |
$16K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
158 |
117 |
$15K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
63 |
44 |
$6K |
| 76818 |
|
54 |
28 |
$6K |
| 99385 |
|
63 |
56 |
$6K |
| 81002 |
|
3,647 |
2,130 |
$5K |
| 81025 |
|
1,133 |
980 |
$4K |
| 88142 |
|
578 |
551 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
114 |
101 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
228 |
191 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
29 |
27 |
$3K |
| 51725 |
|
15 |
15 |
$2K |
| 76830 |
Ultrasound, transvaginal |
19 |
17 |
$2K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
14 |
12 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
24 |
24 |
$579.34 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
86 |
50 |
$281.00 |
| 81003 |
|
129 |
76 |
$126.52 |
| A4550 |
Surgical trays |
337 |
272 |
$102.42 |
| 0500F |
|
1,558 |
892 |
$100.00 |
| 81000 |
|
22 |
20 |
$8.64 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
54 |
39 |
$0.12 |