| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,310 |
2,595 |
$189K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
215 |
215 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
190 |
187 |
$16K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
64 |
63 |
$7K |
| 81002 |
|
2,193 |
1,693 |
$7K |
| 81025 |
|
662 |
647 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
58 |
53 |
$5K |
| 96160 |
|
304 |
304 |
$5K |
| 59430 |
|
44 |
44 |
$4K |
| 59025 |
Fetal non-stress test |
139 |
76 |
$4K |
| 99078 |
|
135 |
89 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
237 |
211 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$751.11 |
| 85018 |
|
152 |
143 |
$418.93 |
| 90756 |
|
12 |
12 |
$301.32 |
| A4550 |
Surgical trays |
37 |
37 |
$235.93 |
| 99071 |
|
28 |
28 |
$81.48 |
| 82120 |
|
12 |
12 |
$56.04 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$44.64 |