| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59514 |
|
488 |
488 |
$392K |
| 59425 |
|
3,999 |
2,735 |
$389K |
| 99215 |
Prolong outpt/office vis |
685 |
684 |
$132K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,516 |
1,448 |
$119K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
194 |
194 |
$21K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
24 |
24 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
25 |
25 |
$3K |
| 76801 |
|
14 |
14 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
14 |
$1K |
| 59430 |
|
12 |
12 |
$1K |
| 85018 |
|
24 |
24 |
$46.33 |