| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
661 |
437 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
505 |
470 |
$20K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
59 |
57 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
40 |
40 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
28 |
28 |
$2K |
| 76801 |
|
14 |
14 |
$1K |
| 59025 |
Fetal non-stress test |
30 |
25 |
$445.50 |
| 81025 |
|
97 |
93 |
$247.78 |
| 36415 |
Collection of venous blood by venipuncture |
250 |
210 |
$0.00 |