| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
1,941 |
1,285 |
$85K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75 |
49 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
31 |
27 |
$2K |
| 59025 |
Fetal non-stress test |
191 |
138 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56 |
51 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
18 |
12 |
$558.65 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
16 |
12 |
$517.68 |
| 90686 |
|
28 |
28 |
$476.09 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
31 |
27 |
$284.49 |
| 81025 |
|
32 |
27 |
$121.41 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
26 |
$0.00 |