| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
310 |
295 |
$290K |
| 90651 |
|
1,082 |
1,054 |
$269K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,762 |
3,902 |
$176K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,506 |
1,007 |
$87K |
| 81514 |
|
499 |
456 |
$76K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,081 |
721 |
$61K |
| 76801 |
|
533 |
393 |
$35K |
| 76830 |
Ultrasound, transvaginal |
315 |
306 |
$30K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
507 |
382 |
$22K |
| 99236 |
Prolong inpt eval add15 m |
100 |
82 |
$15K |
| 11981 |
|
207 |
196 |
$15K |
| 11982 |
|
166 |
160 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
433 |
317 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,045 |
1,020 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
175 |
133 |
$9K |
| 81025 |
|
1,736 |
1,398 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
135 |
126 |
$8K |
| 99205 |
Prolong outpt/office vis |
112 |
79 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
67 |
63 |
$5K |
| 81002 |
|
1,942 |
1,443 |
$4K |
| 76857 |
|
92 |
80 |
$3K |
| 59430 |
|
35 |
27 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
170 |
80 |
$907.51 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
257 |
117 |
$462.56 |