| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,998 |
4,115 |
$254K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,164 |
1,142 |
$70K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,528 |
1,398 |
$63K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
668 |
639 |
$59K |
| H1000 |
Prenatal care, at-risk assessment |
687 |
602 |
$30K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
40 |
38 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
64 |
54 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
42 |
39 |
$3K |
| 81025 |
|
243 |
230 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
63 |
59 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
13 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$827.94 |
| 90674 |
|
30 |
30 |
$826.00 |
| 59025 |
Fetal non-stress test |
22 |
12 |
$448.07 |
| 90658 |
|
30 |
30 |
$258.61 |