| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,496 |
878 |
$112K |
| 0502F |
|
1,696 |
1,156 |
$84K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
75 |
72 |
$5K |
| 59025 |
Fetal non-stress test |
92 |
49 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
27 |
27 |
$673.82 |
| 84703 |
|
44 |
40 |
$315.04 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30 |
27 |
$294.30 |
| 87210 |
|
12 |
12 |
$56.40 |
| 36415 |
Collection of venous blood by venipuncture |
438 |
340 |
$0.00 |