| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,510 |
1,243 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
992 |
849 |
$50K |
| 59430 |
|
377 |
300 |
$12K |
| 99215 |
Prolong outpt/office vis |
110 |
102 |
$7K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
77 |
62 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$659.16 |
| 81025 |
|
134 |
126 |
$626.20 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$607.97 |
| H0049 |
Alcohol and/or drug screening |
62 |
54 |
$596.96 |
| 0503F |
|
376 |
311 |
$0.00 |