| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59840 |
|
522 |
516 |
$117K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,763 |
1,681 |
$92K |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
199 |
197 |
$60K |
| 81025 |
|
5,864 |
5,413 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
895 |
812 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
621 |
580 |
$43K |
| 01966 |
|
307 |
304 |
$35K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
267 |
256 |
$20K |
| 87210 |
|
1,695 |
1,585 |
$16K |
| 85018 |
|
2,035 |
1,944 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
222 |
195 |
$7K |
| T1016 |
Case management, each 15 minutes |
285 |
167 |
$5K |
| 86703 |
|
384 |
368 |
$4K |
| 84703 |
|
484 |
434 |
$3K |
| 99385 |
|
30 |
27 |
$3K |
| 86701 |
|
280 |
254 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
87 |
76 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
542 |
445 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
70 |
68 |
$1K |
| J2788 |
Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.) |
13 |
12 |
$294.14 |
| 81002 |
|
13 |
12 |
$25.04 |
| 99459 |
|
70 |
66 |
$0.00 |