| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,104 |
1,718 |
$119K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
592 |
534 |
$48K |
| 99215 |
Prolong outpt/office vis |
91 |
76 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
49 |
48 |
$3K |
| 59025 |
Fetal non-stress test |
95 |
82 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
31 |
29 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
759 |
699 |
$2K |
| 99078 |
|
57 |
41 |
$2K |
| 59430 |
|
14 |
14 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
202 |
162 |
$856.79 |
| 81025 |
|
82 |
80 |
$632.25 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
27 |
27 |
$577.16 |
| 90715 |
|
14 |
14 |
$554.86 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$519.05 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
17 |
$91.88 |
| 85018 |
|
25 |
25 |
$78.04 |
| 81003 |
|
16 |
16 |
$46.29 |