| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,697 |
4,124 |
$520K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,474 |
2,227 |
$394K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,108 |
1,072 |
$245K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
300 |
290 |
$46K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
399 |
392 |
$32K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
211 |
210 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
297 |
270 |
$13K |
| 76801 |
|
183 |
179 |
$10K |
| 76830 |
Ultrasound, transvaginal |
49 |
46 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
57 |
54 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
26 |
16 |
$949.86 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
163 |
149 |
$565.56 |
| 90686 |
|
40 |
39 |
$531.75 |
| 81025 |
|
12 |
12 |
$15.42 |
| 85018 |
|
14 |
14 |
$8.67 |
| 3074F |
|
30 |
26 |
$0.02 |
| 1160F |
|
310 |
281 |
$0.01 |
| 3008F |
|
260 |
233 |
$0.00 |
| 1036F |
|
122 |
108 |
$0.00 |
| 3078F |
|
87 |
79 |
$0.00 |
| 1159F |
|
74 |
68 |
$0.00 |