| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26,189 |
17,594 |
$1.68M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,182 |
10,273 |
$1.01M |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,624 |
1,571 |
$128K |
| 81002 |
|
37,917 |
28,261 |
$123K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
637 |
612 |
$92K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
892 |
844 |
$81K |
| 81025 |
|
9,914 |
8,990 |
$74K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
52 |
50 |
$58K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
589 |
557 |
$54K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
464 |
400 |
$35K |
| 76830 |
Ultrasound, transvaginal |
360 |
342 |
$35K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
246 |
228 |
$27K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
786 |
744 |
$14K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
520 |
507 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
90 |
85 |
$6K |
| 59430 |
|
26 |
26 |
$3K |
| 76813 |
|
13 |
12 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 90715 |
|
27 |
24 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$805.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
24 |
$381.13 |
| 87210 |
|
81 |
78 |
$301.26 |
| 99072 |
|
260 |
222 |
$0.00 |