| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
84 |
71 |
$114K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,290 |
1,817 |
$84K |
| 59025 |
Fetal non-stress test |
1,736 |
710 |
$50K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
746 |
534 |
$38K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
512 |
444 |
$37K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
362 |
275 |
$21K |
| 59426 |
|
25 |
24 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
564 |
459 |
$13K |
| 59425 |
|
43 |
41 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
193 |
112 |
$10K |
| 81025 |
|
1,533 |
1,196 |
$7K |
| 81002 |
|
2,959 |
2,428 |
$6K |
| 3008F |
|
3,084 |
2,481 |
$4K |
| 76857 |
|
102 |
80 |
$4K |
| 87210 |
|
860 |
711 |
$2K |
| 96127 |
|
481 |
393 |
$2K |
| 90686 |
|
82 |
77 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
100 |
83 |
$1K |
| 0500F |
|
603 |
480 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
160 |
146 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
27 |
24 |
$1K |
| 58300 |
|
14 |
12 |
$813.33 |
| 0502F |
|
5,006 |
2,784 |
$30.00 |
| 3292F |
|
434 |
397 |
$0.00 |
| 0501F |
|
244 |
233 |
$0.00 |
| 0503F |
|
179 |
160 |
$0.00 |