| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
751 |
706 |
$44K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
781 |
729 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
135 |
121 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
39 |
31 |
$101.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$62.61 |
| 0502F |
|
36 |
32 |
$0.00 |