| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
532 |
448 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
142 |
137 |
$17K |
| 59426 |
|
156 |
77 |
$13K |
| 59425 |
|
103 |
70 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
12 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
13 |
$737.53 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$680.30 |
| 90686 |
|
24 |
24 |
$437.69 |