| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
483 |
294 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
273 |
248 |
$6K |
| H2000 |
Comprehensive multidisciplinary evaluation |
31 |
29 |
$3K |
| 99215 |
Prolong outpt/office vis |
16 |
16 |
$2K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
175 |
142 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
44 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$1K |
| 97803 |
|
173 |
153 |
$1K |
| 99401 |
|
169 |
145 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
24 |
24 |
$1K |
| 88141 |
|
20 |
13 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$620.10 |
| 96151 |
|
76 |
66 |
$516.54 |
| 81025 |
|
24 |
24 |
$49.86 |