| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59899 |
|
337 |
254 |
$11K |
| 59841 |
|
202 |
180 |
$7K |
| 99205 |
Prolong outpt/office vis |
235 |
202 |
$5K |
| 76998 |
|
290 |
211 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
326 |
285 |
$2K |
| 88304 |
|
87 |
70 |
$713.40 |
| 85018 |
|
346 |
304 |
$102.60 |
| 86901 |
|
84 |
72 |
$83.44 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
216 |
151 |
$37.48 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
16 |
12 |
$0.00 |
| A9150 |
Non-prescription drugs |
212 |
164 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
187 |
122 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
254 |
177 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
92 |
66 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
266 |
188 |
$0.00 |
| A4550 |
Surgical trays |
52 |
27 |
$0.00 |
| 01965 |
|
102 |
15 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
231 |
185 |
$0.00 |
| 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 |
18 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
27 |
$0.00 |
| S0190 |
Mifepristone, oral, 200 mg |
18 |
12 |
$0.00 |