| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33,618 |
23,409 |
$2.48M |
| 58558 |
|
1,580 |
1,578 |
$2.24M |
| 93975 |
|
4,678 |
4,649 |
$1.28M |
| 76830 |
Ultrasound, transvaginal |
13,434 |
13,047 |
$1.13M |
| 59840 |
|
4,452 |
4,445 |
$1.09M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,105 |
5,999 |
$867K |
| 76801 |
|
8,273 |
8,135 |
$851K |
| 99442 |
|
5,268 |
3,836 |
$550K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,108 |
4,097 |
$424K |
| A4550 |
Surgical trays |
1,397 |
1,388 |
$343K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,766 |
3,716 |
$301K |
| 99205 |
Prolong outpt/office vis |
1,290 |
1,290 |
$218K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,930 |
2,929 |
$189K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,591 |
1,588 |
$188K |
| 99215 |
Prolong outpt/office vis |
1,113 |
1,104 |
$151K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,363 |
1,361 |
$131K |
| S0190 |
Mifepristone, oral, 200 mg |
2,565 |
2,565 |
$131K |
| 76857 |
|
2,030 |
1,951 |
$109K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,315 |
2,307 |
$100K |
| 59841 |
|
239 |
239 |
$96K |
| 57454 |
|
577 |
574 |
$94K |
| 99385 |
|
791 |
791 |
$88K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
477 |
469 |
$56K |
| 81025 |
|
13,664 |
12,716 |
$40K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
268 |
268 |
$36K |
| 99443 |
|
206 |
193 |
$30K |
| 99441 |
|
443 |
390 |
$29K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
299 |
292 |
$21K |
| A4649 |
Surgical supply; miscellaneous |
131 |
131 |
$18K |
| 52204 |
|
45 |
45 |
$16K |
| 57150 |
|
310 |
302 |
$16K |
| 99386 |
|
119 |
119 |
$16K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,554 |
1,551 |
$16K |
| 93976 |
|
3,259 |
3,241 |
$14K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
158 |
145 |
$13K |
| 86901 |
|
6,265 |
6,219 |
$12K |
| 85014 |
|
6,880 |
6,834 |
$11K |
| 00940 |
|
117 |
115 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
3,730 |
3,355 |
$6K |
| S0191 |
Misoprostol, oral, 200 mcg |
2,117 |
2,116 |
$5K |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
27 |
27 |
$5K |
| 01966 |
|
134 |
131 |
$5K |
| 99459 |
|
211 |
211 |
$4K |
| 81000 |
|
1,238 |
1,206 |
$3K |
| 58300 |
|
12 |
12 |
$929.07 |
| 99072 |
|
332 |
313 |
$260.00 |
| 99000 |
|
13 |
13 |
$0.00 |