| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,914 |
2,079 |
$128K |
| 0502F |
|
613 |
454 |
$28K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
244 |
219 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
190 |
109 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
77 |
72 |
$7K |
| 99000 |
|
320 |
196 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
52 |
42 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
342 |
275 |
$3K |
| 76830 |
Ultrasound, transvaginal |
43 |
37 |
$2K |
| 59025 |
Fetal non-stress test |
58 |
27 |
$2K |
| 99459 |
|
102 |
90 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
15 |
14 |
$969.95 |
| 81025 |
|
243 |
150 |
$845.99 |
| 0503F |
|
15 |
12 |
$800.40 |
| 76801 |
|
14 |
13 |
$665.10 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
12 |
$578.88 |
| 81002 |
|
181 |
149 |
$440.68 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
32 |
31 |
$375.38 |
| 96127 |
|
16 |
13 |
$247.63 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
19 |
19 |
$121.38 |
| 99334 |
|
13 |
13 |
$16.00 |
| 1036F |
|
1,841 |
1,067 |
$0.00 |