| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,696 |
1,377 |
$130K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
381 |
333 |
$46K |
| 59025 |
Fetal non-stress test |
395 |
112 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
222 |
188 |
$13K |
| 76830 |
Ultrasound, transvaginal |
116 |
94 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
14 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$239.10 |
| 0503F |
|
29 |
27 |
$100.00 |
| 81025 |
|
13 |
13 |
$75.51 |
| 0500F |
|
82 |
79 |
$50.00 |
| 0501F |
|
2,937 |
1,527 |
$0.00 |
| 0502F |
|
2,897 |
1,510 |
$0.00 |