| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,397 |
2,779 |
$187K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,834 |
3,723 |
$145K |
| H1010 |
Non-medical family planning education, per session |
5,527 |
4,210 |
$56K |
| 99215 |
Prolong outpt/office vis |
401 |
286 |
$25K |
| 81025 |
|
3,319 |
2,908 |
$22K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
282 |
281 |
$19K |
| 81002 |
|
4,983 |
2,935 |
$13K |
| 76801 |
|
137 |
113 |
$12K |
| 87210 |
|
2,195 |
2,068 |
$10K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
142 |
116 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
405 |
381 |
$4K |
| 82947 |
|
1,147 |
941 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
62 |
39 |
$3K |
| 99205 |
Prolong outpt/office vis |
24 |
24 |
$2K |
| 59025 |
Fetal non-stress test |
61 |
44 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
29 |
24 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
28 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
20 |
12 |
$1K |
| 59430 |
|
27 |
13 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$931.63 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$523.84 |
| 96127 |
|
8,056 |
4,962 |
$19.77 |