| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
601 |
506 |
$25K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
24 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
623 |
516 |
$1K |
| 90686 |
|
38 |
34 |
$621.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
34 |
$370.45 |
| 81025 |
|
32 |
24 |
$149.35 |
| 0502F |
|
39 |
30 |
$10.00 |