| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
2,104 |
1,216 |
$92K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
260 |
240 |
$18K |
| 59025 |
Fetal non-stress test |
647 |
564 |
$7K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
80 |
75 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
31 |
24 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
50 |
31 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
26 |
25 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
27 |
27 |
$1K |
| 76801 |
|
14 |
14 |
$1K |
| 90686 |
|
57 |
45 |
$1K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$899.21 |
| 0500F |
|
20 |
20 |
$882.00 |
| 90715 |
|
25 |
13 |
$808.31 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
16 |
15 |
$327.33 |
| 36415 |
Collection of venous blood by venipuncture |
172 |
162 |
$4.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
27 |
$0.00 |