| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
409 |
378 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
82 |
74 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
79 |
70 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
79 |
65 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
55 |
$4K |
| 59025 |
Fetal non-stress test |
88 |
51 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
27 |
27 |
$3K |
| 0500F |
|
162 |
152 |
$560.00 |
| 81025 |
|
20 |
19 |
$78.34 |
| 0503F |
|
43 |
39 |
$40.00 |