| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
4,128 |
3,017 |
$181K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,632 |
1,290 |
$69K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
321 |
293 |
$22K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$12K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
104 |
102 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
100 |
56 |
$7K |
| 0500F |
|
128 |
124 |
$6K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
40 |
39 |
$3K |
| 90686 |
|
117 |
95 |
$2K |
| 90715 |
|
60 |
42 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
130 |
93 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$979.08 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
66 |
66 |
$857.35 |
| 99234 |
|
13 |
13 |
$765.05 |
| 0503F |
|
12 |
12 |
$601.80 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$514.80 |
| 59025 |
Fetal non-stress test |
44 |
27 |
$416.05 |
| 36415 |
Collection of venous blood by venipuncture |
298 |
271 |
$41.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
146 |
117 |
$0.00 |
| 1160F |
|
77 |
63 |
$0.00 |