| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
3,090 |
1,532 |
$136K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
883 |
757 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
98 |
64 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
72 |
69 |
$4K |
| 76830 |
Ultrasound, transvaginal |
75 |
74 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
30 |
25 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
25 |
24 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
88 |
77 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
118 |
94 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
12 |
$675.78 |
| 90686 |
|
16 |
16 |
$321.91 |
| 87210 |
|
53 |
52 |
$251.26 |
| 90688 |
|
13 |
13 |
$209.04 |
| 81002 |
|
390 |
256 |
$192.66 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
13 |
$0.00 |