| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,077 |
910 |
$49K |
| 76830 |
Ultrasound, transvaginal |
346 |
313 |
$27K |
| 59025 |
Fetal non-stress test |
218 |
174 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
46 |
37 |
$4K |
| 54150 |
|
15 |
14 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$994.92 |
| 36415 |
Collection of venous blood by venipuncture |
244 |
191 |
$510.66 |
| 81025 |
|
89 |
79 |
$476.15 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
13 |
$278.82 |
| 87210 |
|
15 |
12 |
$61.16 |
| 0502F |
|
1,373 |
1,122 |
$0.00 |