| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
630 |
577 |
$35K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
116 |
116 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
110 |
102 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
56 |
41 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
123 |
121 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$1K |
| 59025 |
Fetal non-stress test |
35 |
15 |
$917.98 |
| 36415 |
Collection of venous blood by venipuncture |
294 |
268 |
$902.80 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$674.49 |