| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
401 |
332 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
93 |
84 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
95 |
79 |
$6K |
| 81002 |
|
1,297 |
966 |
$3K |
| 76830 |
Ultrasound, transvaginal |
49 |
47 |
$1K |
| 81025 |
|
213 |
178 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
45 |
39 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$991.45 |
| 90715 |
|
15 |
13 |
$652.66 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
17 |
16 |
$496.39 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
13 |
$253.48 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
13 |
$175.74 |
| 0503F |
|
13 |
12 |
$0.02 |
| 0502F |
|
668 |
492 |
$0.00 |