| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,378 |
2,799 |
$183K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
155 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
87 |
87 |
$9K |
| 81002 |
|
2,883 |
2,348 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
347 |
343 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
56 |
55 |
$4K |
| 81025 |
|
385 |
362 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
26 |
24 |
$2K |
| 85018 |
|
712 |
688 |
$2K |
| 81003 |
|
608 |
592 |
$2K |
| 59430 |
|
12 |
12 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$1K |