| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
551 |
283 |
$59K |
| 0502F |
|
771 |
505 |
$51K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
295 |
230 |
$21K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
47 |
26 |
$2K |
| 59025 |
Fetal non-stress test |
37 |
15 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$858.99 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
15 |
12 |
$139.20 |