| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,063 |
7,877 |
$564K |
| 59426 |
|
157 |
156 |
$146K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,152 |
2,074 |
$13K |
| 59430 |
|
196 |
195 |
$11K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
132 |
132 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
845 |
827 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
476 |
473 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
264 |
264 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
332 |
320 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
286 |
268 |
$709.88 |
| 81025 |
|
837 |
824 |
$677.15 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
14 |
$391.07 |
| 36415 |
Collection of venous blood by venipuncture |
591 |
566 |
$388.70 |
| 59025 |
Fetal non-stress test |
84 |
39 |
$210.24 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
26 |
25 |
$131.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
13 |
$106.93 |
| 80305 |
|
36 |
36 |
$99.56 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
14 |
14 |
$95.48 |
| 58300 |
|
24 |
24 |
$51.51 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
24 |
$35.00 |