| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
694 |
692 |
$1.38M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,022 |
5,658 |
$358K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,234 |
3,051 |
$320K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,234 |
1,202 |
$319K |
| G9005 |
Coordinated care fee, risk adjusted maintenance |
1,163 |
1,162 |
$317K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,790 |
1,771 |
$156K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,103 |
1,056 |
$110K |
| 76801 |
|
512 |
495 |
$74K |
| S9999 |
Sales tax |
6,612 |
2,968 |
$66K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
499 |
253 |
$60K |
| 81003 |
|
25,408 |
17,414 |
$57K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
590 |
583 |
$51K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
620 |
594 |
$47K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,681 |
1,663 |
$37K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
947 |
913 |
$35K |
| 81025 |
|
3,515 |
3,447 |
$28K |
| 99215 |
Prolong outpt/office vis |
227 |
217 |
$27K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
162 |
161 |
$25K |
| 76830 |
Ultrasound, transvaginal |
248 |
239 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
109 |
108 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,019 |
892 |
$16K |
| 99219 |
|
152 |
142 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
4,200 |
3,795 |
$12K |
| 84443 |
Thyroid stimulating hormone (TSH) |
700 |
685 |
$12K |
| 81001 |
|
2,644 |
2,415 |
$9K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
994 |
973 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
49 |
49 |
$5K |
| 80055 |
|
56 |
56 |
$3K |
| 82951 |
|
220 |
206 |
$3K |
| 99205 |
Prolong outpt/office vis |
19 |
19 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
26 |
$3K |
| 99385 |
|
12 |
12 |
$2K |
| 87210 |
|
248 |
243 |
$1K |
| 59899 |
|
12 |
12 |
$1K |
| 77080 |
|
29 |
28 |
$905.80 |
| 77065 |
Tomosynthesis, mammo |
12 |
12 |
$891.71 |
| 80053 |
Comprehensive metabolic panel |
40 |
40 |
$813.60 |
| 94760 |
|
607 |
569 |
$748.25 |
| 59025 |
Fetal non-stress test |
12 |
12 |
$373.35 |
| 90756 |
|
13 |
13 |
$362.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$276.74 |
| 99000 |
|
213 |
207 |
$150.24 |
| 99072 |
|
2,188 |
1,697 |
$58.73 |
| 83986 |
|
12 |
12 |
$36.97 |
| 0502F |
|
3,456 |
2,295 |
$0.08 |
| 0501F |
|
3,488 |
2,308 |
$0.08 |
| 0500F |
|
152 |
149 |
$0.00 |
| 0503F |
|
61 |
59 |
$0.00 |