| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,423 |
1,052 |
$41K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
29 |
29 |
$30K |
| 99205 |
Prolong outpt/office vis |
159 |
157 |
$24K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
155 |
154 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$10K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
111 |
89 |
$7K |
| 58300 |
|
31 |
31 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
80 |
80 |
$3K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
68 |
68 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
68 |
60 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
428 |
404 |
$1K |
| 81025 |
|
124 |
123 |
$972.94 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
65 |
64 |
$952.43 |
| 64435 |
|
31 |
31 |
$942.96 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$839.71 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$749.02 |
| 90686 |
|
14 |
14 |
$250.78 |
| 87210 |
|
28 |
25 |
$117.44 |
| 83986 |
|
14 |
12 |
$39.03 |