| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
837 |
405 |
$16K |
| 81002 |
|
1,835 |
1,140 |
$3K |
| 59425 |
|
403 |
275 |
$834.23 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
317 |
299 |
$577.09 |
| 59430 |
|
41 |
30 |
$370.10 |
| 76830 |
Ultrasound, transvaginal |
66 |
60 |
$152.88 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
37 |
32 |
$106.84 |
| 59025 |
Fetal non-stress test |
58 |
26 |
$99.18 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
158 |
121 |
$72.34 |
| 36415 |
Collection of venous blood by venipuncture |
173 |
154 |
$28.50 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$0.00 |
| 99234 |
|
16 |
14 |
$0.00 |
| 87210 |
|
35 |
31 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
31 |
31 |
$0.00 |