| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99401 |
|
1,767 |
1,692 |
$52K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
308 |
276 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
274 |
230 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
118 |
107 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
417 |
327 |
$7K |
| 87806 |
|
177 |
163 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
58 |
54 |
$2K |
| 81025 |
|
371 |
312 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
22 |
19 |
$1K |
| 85018 |
|
364 |
319 |
$797.62 |
| 86901 |
|
189 |
177 |
$787.30 |
| 99070 |
|
14 |
14 |
$455.00 |
| 87210 |
|
69 |
65 |
$284.35 |
| 83986 |
|
69 |
65 |
$212.96 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
26 |
18 |
$177.49 |