| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,004 |
732 |
$56K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
209 |
202 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
301 |
241 |
$10K |
| 81003 |
|
1,706 |
1,243 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
47 |
42 |
$3K |
| 59025 |
Fetal non-stress test |
115 |
75 |
$2K |
| 81025 |
|
247 |
220 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
18 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
377 |
318 |
$919.01 |
| 87210 |
|
194 |
92 |
$861.43 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
226 |
218 |
$823.84 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
14 |
14 |
$342.00 |