| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,724 |
1,368 |
$114K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,112 |
1,720 |
$98K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
128 |
123 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
698 |
660 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
16 |
16 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
26 |
25 |
$379.65 |
| 87210 |
|
53 |
50 |
$213.86 |
| 81025 |
|
31 |
29 |
$202.83 |
| H1000 |
Prenatal care, at-risk assessment |
14 |
12 |
$163.37 |