| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 58558 |
|
19,064 |
9,544 |
$4.22M |
| 76830 |
Ultrasound, transvaginal |
36,825 |
23,122 |
$1.46M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30,671 |
21,664 |
$1.26M |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
29,649 |
20,013 |
$1.18M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
8,438 |
5,313 |
$465K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,131 |
8,457 |
$331K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
13,132 |
7,678 |
$170K |
| 52000 |
|
3,912 |
2,309 |
$157K |
| 81025 |
|
25,790 |
17,280 |
$80K |
| 76857 |
|
4,281 |
1,866 |
$57K |
| 57425 |
|
173 |
82 |
$40K |
| 99205 |
Prolong outpt/office vis |
634 |
363 |
$38K |
| 99152 |
|
672 |
339 |
$34K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
540 |
410 |
$27K |
| 58555 |
|
171 |
141 |
$25K |
| 99215 |
Prolong outpt/office vis |
456 |
277 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
425 |
221 |
$13K |
| 58662 |
|
52 |
28 |
$12K |
| 58571 |
|
48 |
24 |
$11K |
| 52005 |
|
122 |
76 |
$9K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
575 |
443 |
$9K |
| 93925 |
|
239 |
165 |
$8K |
| 58100 |
|
177 |
130 |
$8K |
| 57452 |
|
343 |
170 |
$7K |
| 58661 |
|
28 |
13 |
$6K |
| 56820 |
|
178 |
107 |
$5K |
| 57500 |
|
214 |
121 |
$5K |
| 81003 |
|
4,742 |
3,139 |
$4K |
| 81002 |
|
3,280 |
2,198 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
341 |
160 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
54 |
38 |
$4K |
| 51725 |
|
89 |
49 |
$4K |
| 57505 |
|
128 |
54 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
31 |
16 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
39 |
24 |
$2K |
| 51736 |
|
89 |
49 |
$394.87 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
126 |
80 |
$311.77 |
| 76937 |
|
25 |
17 |
$166.21 |
| 83986 |
|
261 |
152 |
$147.36 |
| 93000 |
|
24 |
12 |
$68.20 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
104 |
72 |
$66.95 |
| 81000 |
|
22 |
14 |
$27.89 |
| 0502F |
|
121 |
71 |
$0.00 |