| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
153 |
138 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
159 |
121 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
266 |
198 |
$9K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
87 |
66 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
141 |
99 |
$4K |
| 90670 |
|
104 |
91 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
160 |
113 |
$1K |
| 99381 |
|
17 |
14 |
$910.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
23 |
18 |
$840.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
17 |
13 |
$785.85 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
12 |
$714.74 |
| 81002 |
|
251 |
170 |
$572.61 |
| 90648 |
|
41 |
32 |
$554.12 |
| 90698 |
|
30 |
29 |
$534.33 |
| 81025 |
|
203 |
148 |
$364.80 |
| 90680 |
|
19 |
19 |
$336.43 |
| 90744 |
|
12 |
12 |
$237.48 |
| 36416 |
|
82 |
65 |
$172.50 |
| 36415 |
Collection of venous blood by venipuncture |
75 |
53 |
$106.00 |