| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
4,188 |
2,849 |
$219K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,613 |
1,240 |
$104K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,131 |
860 |
$59K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
486 |
363 |
$52K |
| 59430 |
|
99 |
84 |
$14K |
| 59025 |
Fetal non-stress test |
439 |
258 |
$10K |
| 0503F |
|
110 |
102 |
$8K |
| 0500F |
|
78 |
68 |
$4K |
| 96127 |
|
235 |
205 |
$4K |
| 90686 |
|
76 |
55 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
12 |
$374.49 |
| 81025 |
|
27 |
25 |
$115.40 |
| 36415 |
Collection of venous blood by venipuncture |
147 |
123 |
$24.60 |
| 1036F |
|
159 |
128 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
12 |
$0.00 |