| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,695 |
4,178 |
$206K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,066 |
1,041 |
$59K |
| 76801 |
|
512 |
499 |
$24K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,399 |
1,247 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
234 |
226 |
$14K |
| 81025 |
|
2,180 |
2,088 |
$10K |
| T1015 |
Clinic visit/encounter, all-inclusive |
51 |
41 |
$9K |
| 59426 |
|
12 |
12 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
137 |
132 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
97 |
94 |
$6K |
| 99401 |
|
157 |
149 |
$4K |
| S0612 |
Annual gynecological examination, established patient |
69 |
69 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
455 |
438 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
80 |
80 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
99 |
88 |
$3K |
| 59430 |
|
13 |
13 |
$1K |
| 81002 |
|
317 |
302 |
$592.32 |
| 87210 |
|
91 |
91 |
$294.26 |
| 90674 |
|
13 |
13 |
$0.60 |