| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,065 |
3,025 |
$204K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,733 |
1,733 |
$160K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,355 |
1,312 |
$124K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,163 |
1,163 |
$89K |
| 76830 |
Ultrasound, transvaginal |
475 |
475 |
$47K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
150 |
126 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
620 |
597 |
$9K |
| 99385 |
|
48 |
48 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
61 |
50 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
42 |
42 |
$4K |
| 81002 |
|
1,232 |
1,223 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
25 |
$3K |
| 96127 |
|
654 |
654 |
$3K |
| 81025 |
|
360 |
349 |
$2K |
| 90715 |
|
28 |
28 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$232.56 |