| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
1,788 |
1,121 |
$78K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
88 |
63 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
87 |
69 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17 |
16 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$1K |
| 90686 |
|
38 |
34 |
$668.37 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$631.88 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
52 |
39 |
$503.25 |
| 81025 |
|
34 |
29 |
$139.53 |
| 36415 |
Collection of venous blood by venipuncture |
74 |
61 |
$45.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
51 |
39 |
$0.00 |