| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,838 |
1,898 |
$320K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,955 |
1,787 |
$296K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,244 |
791 |
$146K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,728 |
780 |
$121K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,685 |
443 |
$90K |
| 59840 |
|
70 |
70 |
$56K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
387 |
351 |
$42K |
| 99201 |
|
534 |
205 |
$40K |
| 99401 |
|
669 |
641 |
$23K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
448 |
441 |
$18K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
26 |
26 |
$16K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
339 |
338 |
$10K |
| 76830 |
Ultrasound, transvaginal |
52 |
50 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
358 |
206 |
$7K |
| 99051 |
|
565 |
533 |
$7K |
| 99385 |
|
191 |
27 |
$5K |
| 86901 |
|
145 |
145 |
$5K |
| 81025 |
|
1,184 |
1,151 |
$4K |
| S0190 |
Mifepristone, oral, 200 mg |
47 |
47 |
$4K |
| 11981 |
|
12 |
12 |
$3K |
| 87806 |
|
252 |
252 |
$3K |
| 90651 |
|
37 |
37 |
$2K |
| 86703 |
|
233 |
231 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
56 |
55 |
$727.65 |
| 36415 |
Collection of venous blood by venipuncture |
477 |
447 |
$362.56 |
| 81002 |
|
441 |
398 |
$307.59 |
| 87210 |
|
612 |
598 |
$291.14 |
| 96127 |
|
558 |
558 |
$261.88 |
| 88174 |
|
12 |
12 |
$231.44 |
| 84702 |
|
21 |
15 |
$227.46 |
| 85018 |
|
385 |
379 |
$174.60 |
| 86701 |
|
13 |
13 |
$115.93 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
205 |
204 |
$113.51 |
| 36416 |
|
944 |
932 |
$102.00 |
| 83986 |
|
541 |
530 |
$88.33 |
| 86803 |
|
14 |
13 |
$32.14 |
| 86592 |
|
94 |
93 |
$26.15 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
41 |
$22.58 |
| S0191 |
Misoprostol, oral, 200 mcg |
12 |
12 |
$13.90 |
| 96160 |
|
520 |
520 |
$9.15 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
15 |
15 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
15 |
15 |
$0.00 |
| 64435 |
|
14 |
14 |
$0.00 |
| A4550 |
Surgical trays |
27 |
27 |
$0.00 |
| 99152 |
|
15 |
15 |
$0.00 |