| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
3,657 |
1,813 |
$178K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,508 |
1,333 |
$88K |
| 59025 |
Fetal non-stress test |
2,652 |
975 |
$75K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
888 |
699 |
$45K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
566 |
310 |
$38K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
499 |
467 |
$33K |
| 76830 |
Ultrasound, transvaginal |
272 |
263 |
$17K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
172 |
169 |
$14K |
| 76801 |
|
81 |
81 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
42 |
41 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
253 |
174 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
68 |
47 |
$2K |
| 0500F |
|
26 |
26 |
$1K |
| 81025 |
|
387 |
341 |
$964.80 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
19 |
14 |
$807.17 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
23 |
18 |
$807.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
22 |
18 |
$796.72 |
| 59430 |
|
12 |
12 |
$601.80 |
| 81003 |
|
190 |
177 |
$401.39 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
15 |
15 |
$276.15 |
| H1000 |
Prenatal care, at-risk assessment |
13 |
13 |
$189.80 |
| 36415 |
Collection of venous blood by venipuncture |
474 |
351 |
$135.30 |
| 81001 |
|
61 |
47 |
$102.96 |
| 85027 |
|
18 |
16 |
$97.58 |
| 81002 |
|
31 |
28 |
$75.70 |
| 87210 |
|
17 |
16 |
$61.10 |