| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
583 |
519 |
$38K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
194 |
152 |
$20K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
45 |
40 |
$3K |
| 0002A |
|
33 |
33 |
$1K |
| 0001A |
|
34 |
34 |
$1K |
| 90756 |
|
12 |
12 |
$336.57 |
| 81025 |
|
28 |
27 |
$191.66 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
14 |
$121.10 |
| 36415 |
Collection of venous blood by venipuncture |
40 |
35 |
$98.16 |
| 91300 |
|
74 |
72 |
$0.07 |
| 99000 |
|
31 |
29 |
$0.00 |