| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
3,079 |
1,875 |
$134K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
863 |
764 |
$38K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
301 |
263 |
$23K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
372 |
323 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
210 |
157 |
$13K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$11K |
| 59025 |
Fetal non-stress test |
1,147 |
634 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
94 |
87 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
120 |
112 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
482 |
371 |
$4K |
| 54150 |
|
41 |
41 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
81 |
75 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
17 |
$436.05 |
| 90715 |
|
16 |
12 |
$314.05 |
| 81025 |
|
32 |
26 |
$162.85 |
| 99000 |
|
199 |
179 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
12 |
$0.00 |