| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,586 |
1,740 |
$108K |
| 59426 |
|
355 |
146 |
$23K |
| 59425 |
|
252 |
155 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
226 |
169 |
$13K |
| 81000 |
|
3,273 |
2,012 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
44 |
26 |
$2K |
| 59025 |
Fetal non-stress test |
158 |
63 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
19 |
12 |
$1K |
| 76801 |
|
16 |
14 |
$924.10 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
12 |
$611.82 |
| 81025 |
|
16 |
15 |
$98.25 |