| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25,862 |
22,539 |
$1.11M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,278 |
19,976 |
$919K |
| T2023 |
Targeted case management; per month |
1,336 |
1,336 |
$391K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,679 |
3,505 |
$222K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
1,049 |
1,039 |
$201K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
1,087 |
1,075 |
$197K |
| 76830 |
Ultrasound, transvaginal |
1,034 |
1,001 |
$93K |
| T1001 |
Nursing assessment / evaluation |
333 |
323 |
$60K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
448 |
412 |
$46K |
| 90651 |
|
427 |
422 |
$24K |
| 90715 |
|
2,315 |
2,276 |
$24K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
600 |
575 |
$21K |
| 99215 |
Prolong outpt/office vis |
223 |
155 |
$17K |
| 76801 |
|
138 |
134 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
856 |
843 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
173 |
171 |
$13K |
| 99429 |
|
44 |
44 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
422 |
421 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
2,868 |
2,692 |
$8K |
| S0612 |
Annual gynecological examination, established patient |
243 |
240 |
$7K |
| 90686 |
|
358 |
350 |
$2K |
| 81025 |
|
495 |
478 |
$2K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
212 |
211 |
$2K |
| 81002 |
|
552 |
496 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
29 |
20 |
$608.20 |
| 99385 |
|
14 |
14 |
$342.20 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$288.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
77 |
77 |
$80.30 |
| 87210 |
|
12 |
12 |
$77.12 |
| 90656 |
|
78 |
78 |
$0.00 |
| 0503F |
|
27 |
26 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
29 |
28 |
$0.00 |
| 90678 |
|
15 |
15 |
$0.00 |