| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,297 |
1,202 |
$145K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,094 |
1,041 |
$105K |
| 59426 |
|
98 |
95 |
$79K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
300 |
158 |
$35K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
206 |
202 |
$27K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$24K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
199 |
175 |
$21K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
214 |
187 |
$21K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
98 |
94 |
$14K |
| 81025 |
|
1,419 |
1,329 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
85 |
75 |
$8K |
| 81003 |
|
3,325 |
2,388 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
255 |
219 |
$4K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
30 |
30 |
$3K |
| 59430 |
|
16 |
16 |
$2K |
| 99000 |
|
212 |
160 |
$8.77 |
| 0502F |
|
12 |
12 |
$0.00 |