| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
3,385 |
1,845 |
$326K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,085 |
2,639 |
$245K |
| 59425 |
|
2,386 |
1,853 |
$205K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,048 |
1,672 |
$167K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,073 |
1,744 |
$104K |
| 76801 |
|
1,101 |
930 |
$84K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,215 |
917 |
$66K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
607 |
577 |
$47K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
251 |
240 |
$27K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
355 |
336 |
$22K |
| 59515 |
|
32 |
25 |
$21K |
| 36415 |
Collection of venous blood by venipuncture |
3,927 |
3,367 |
$12K |
| 80305 |
|
1,097 |
1,011 |
$10K |
| 81025 |
|
1,541 |
1,430 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
119 |
109 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
932 |
774 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
70 |
59 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
28 |
26 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
21 |
12 |
$1K |
| 90686 |
|
62 |
57 |
$887.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
66 |
61 |
$641.85 |
| 81002 |
|
76 |
66 |
$162.75 |
| 99401 |
|
17 |
16 |
$32.50 |
| 99459 |
|
20 |
17 |
$8.80 |
| 3078F |
|
758 |
687 |
$0.00 |
| 1159F |
|
1,581 |
1,356 |
$0.00 |
| 0502F |
|
53 |
31 |
$0.00 |
| 3008F |
|
1,473 |
1,279 |
$0.00 |
| 3074F |
|
984 |
872 |
$0.00 |
| 0503F |
|
98 |
85 |
$0.00 |
| 3079F |
|
133 |
114 |
$0.00 |
| 1111F |
|
62 |
51 |
$0.00 |