| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,355 |
1,175 |
$99K |
| 99215 |
Prolong outpt/office vis |
888 |
842 |
$90K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
26 |
26 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,077 |
2,930 |
$32K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
457 |
427 |
$30K |
| 76830 |
Ultrasound, transvaginal |
369 |
357 |
$27K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
186 |
181 |
$17K |
| 76801 |
|
181 |
169 |
$14K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
101 |
96 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
68 |
64 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
409 |
386 |
$7K |
| 59025 |
Fetal non-stress test |
137 |
47 |
$5K |
| 99205 |
Prolong outpt/office vis |
28 |
28 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
25 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
32 |
31 |
$2K |
| 81025 |
|
188 |
179 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
62 |
60 |
$832.50 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
14 |
$824.00 |