| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99070 |
|
158 |
143 |
$133K |
| 99205 |
Prolong outpt/office vis |
233 |
217 |
$24K |
| 59841 |
|
51 |
47 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
169 |
151 |
$6K |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
40 |
39 |
$3K |
| S0190 |
Mifepristone, oral, 200 mg |
41 |
40 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
15 |
$546.80 |
| J2704 |
Injection, propofol, 10 mg |
97 |
75 |
$218.91 |
| 85018 |
|
258 |
242 |
$117.86 |
| 86901 |
|
55 |
46 |
$21.17 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
16 |
12 |
$20.16 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
86 |
72 |
$17.98 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
35 |
27 |
$1.80 |
| S0030 |
Injection, metronidazole, 500 mg |
50 |
42 |
$0.00 |
| 76998 |
|
51 |
47 |
$0.00 |