| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,929 |
1,273 |
$84K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
613 |
415 |
$19K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
157 |
153 |
$12K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
88 |
75 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
57 |
55 |
$4K |
| 81002 |
|
2,039 |
1,209 |
$3K |
| 99441 |
|
149 |
112 |
$3K |
| 99000 |
|
207 |
182 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
28 |
26 |
$1K |
| 99385 |
|
17 |
17 |
$1K |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
39 |
38 |
$915.71 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
47 |
47 |
$640.90 |
| 81025 |
|
83 |
82 |
$473.80 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$342.00 |
| 88142 |
|
99 |
95 |
$285.88 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
14 |
$114.09 |