| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
92 |
86 |
$6K |
| 76830 |
Ultrasound, transvaginal |
60 |
55 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
90 |
82 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
57 |
55 |
$3K |
| 59025 |
Fetal non-stress test |
19 |
12 |
$948.56 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$809.90 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$386.42 |
| 81025 |
|
61 |
59 |
$356.36 |
| 81002 |
|
101 |
99 |
$0.00 |