| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59025 |
Fetal non-stress test |
667 |
448 |
$162K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
728 |
516 |
$155K |
| 76818 |
|
611 |
416 |
$154K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
940 |
584 |
$92K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,810 |
1,491 |
$52K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
343 |
295 |
$30K |
| 81002 |
|
2,485 |
1,886 |
$28K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
190 |
135 |
$23K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
159 |
152 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
54 |
53 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
74 |
69 |
$2K |
| 86780 |
|
41 |
41 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
24 |
$2K |
| 87150 |
|
26 |
26 |
$1K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
14 |
14 |
$781.09 |
| G0109 |
Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes |
15 |
12 |
$260.85 |
| 3078F |
|
56 |
39 |
$0.56 |