| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
2,615 |
1,539 |
$136K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
387 |
336 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
194 |
135 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
168 |
165 |
$11K |
| 59025 |
Fetal non-stress test |
330 |
175 |
$10K |
| 76801 |
|
40 |
39 |
$3K |
| 90686 |
|
17 |
15 |
$323.51 |
| 36415 |
Collection of venous blood by venipuncture |
79 |
68 |
$41.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
20 |
16 |
$0.00 |