| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
560 |
492 |
$38K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
127 |
97 |
$13K |
| 76818 |
|
64 |
25 |
$5K |
| 59025 |
Fetal non-stress test |
118 |
38 |
$3K |
| 0002A |
|
39 |
39 |
$1K |
| 0001A |
|
37 |
37 |
$1K |
| 90756 |
|
14 |
14 |
$390.84 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21 |
14 |
$243.57 |
| 36415 |
Collection of venous blood by venipuncture |
77 |
68 |
$186.71 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
14 |
$112.77 |
| 81025 |
|
12 |
12 |
$85.84 |
| 91300 |
|
35 |
34 |
$0.00 |
| 99000 |
|
78 |
69 |
$0.00 |