| Code | Description | Claims | Beneficiaries | Total Paid |
| 59426 |
|
114 |
53 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
76 |
71 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
154 |
141 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
78 |
67 |
$2K |
| 59425 |
|
20 |
16 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$2K |
| 59025 |
Fetal non-stress test |
30 |
14 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
323 |
277 |
$802.92 |
| 81025 |
|
86 |
83 |
$528.48 |