| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
5,297 |
3,510 |
$246K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,331 |
1,824 |
$138K |
| 59025 |
Fetal non-stress test |
1,418 |
744 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
433 |
403 |
$33K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
336 |
314 |
$28K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
247 |
236 |
$21K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
152 |
134 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
67 |
38 |
$4K |
| 76830 |
Ultrasound, transvaginal |
45 |
42 |
$3K |
| 81025 |
|
574 |
452 |
$2K |
| 0503F |
|
29 |
26 |
$1K |
| 99386 |
|
12 |
12 |
$1K |
| 58100 |
|
17 |
13 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
17 |
15 |
$647.10 |
| 96127 |
|
25 |
24 |
$357.88 |
| 99459 |
|
13 |
13 |
$190.06 |
| 3014F |
|
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
29 |
29 |
$0.00 |