| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
2,295 |
1,596 |
$109K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,234 |
755 |
$91K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
262 |
225 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
94 |
75 |
$7K |
| 59025 |
Fetal non-stress test |
139 |
80 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
412 |
318 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
26 |
25 |
$2K |
| 0500F |
|
26 |
26 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
13 |
$790.90 |
| 81025 |
|
12 |
12 |
$30.96 |
| 36415 |
Collection of venous blood by venipuncture |
289 |
248 |
$0.00 |