| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59840 |
|
215 |
210 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
408 |
381 |
$3K |
| 81025 |
|
464 |
410 |
$1K |
| 86901 |
|
339 |
295 |
$58.60 |
| 85018 |
|
340 |
296 |
$48.93 |
| 99205 |
Prolong outpt/office vis |
251 |
245 |
$0.00 |
| S0190 |
Mifepristone, oral, 200 mg |
138 |
136 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
116 |
109 |
$0.00 |
| S0191 |
Misoprostol, oral, 200 mcg |
137 |
135 |
$0.00 |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
138 |
136 |
$0.00 |