| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
274 |
250 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
129 |
123 |
$10K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
13 |
13 |
$951.48 |
| 81025 |
|
129 |
125 |
$685.08 |
| 0500F |
|
13 |
13 |
$0.00 |