| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,408 |
1,044 |
$82K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,500 |
1,077 |
$65K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
807 |
561 |
$40K |
| 81025 |
|
1,456 |
1,077 |
$6K |
| 81000 |
|
1,385 |
1,020 |
$2K |
| 86901 |
|
1,301 |
955 |
$2K |
| 85018 |
|
1,310 |
956 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
158 |
140 |
$217.87 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
107 |
98 |
$70.23 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
69 |
62 |
$21.92 |
| J3490 |
Unclassified drugs |
163 |
144 |
$3.19 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
72 |
58 |
$1.71 |
| 59840 |
|
15 |
15 |
$0.00 |