| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,043 |
2,403 |
$79K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
459 |
430 |
$24K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
13 |
12 |
$20K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
464 |
358 |
$11K |
| 81025 |
|
2,398 |
2,025 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
250 |
207 |
$3K |
| G9357 |
Post-partum screenings, evaluations and education performed |
34 |
26 |
$2K |
| 54150 |
|
14 |
12 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
108 |
79 |
$2K |
| 87210 |
|
406 |
360 |
$1K |
| 76801 |
|
47 |
41 |
$1K |
| 90682 |
|
15 |
15 |
$848.38 |
| 59426 |
|
87 |
81 |
$736.50 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
15 |
12 |
$682.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
17 |
12 |
$570.74 |
| 59025 |
Fetal non-stress test |
14 |
12 |
$217.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
52 |
45 |
$200.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$120.00 |
| 85018 |
|
265 |
234 |
$108.00 |
| 99459 |
|
16 |
16 |
$74.28 |
| 59430 |
|
12 |
12 |
$50.00 |
| 81000 |
|
6,169 |
3,247 |
$24.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.00 |
| 85014 |
|
48 |
47 |
$0.00 |
| 59425 |
|
27 |
27 |
$0.00 |