| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,116 |
2,447 |
$161K |
| 59426 |
|
1,551 |
650 |
$152K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
767 |
603 |
$70K |
| 59425 |
|
491 |
355 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
115 |
109 |
$9K |
| 81025 |
|
1,407 |
1,195 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
154 |
122 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
29 |
24 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 59025 |
Fetal non-stress test |
39 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
15 |
$70.08 |