| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76819 |
Fetal biophysical profile; without non-stress testing |
4,068 |
1,412 |
$307K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
79 |
79 |
$265K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,027 |
1,843 |
$190K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,027 |
4,575 |
$133K |
| 59410 |
|
28 |
27 |
$32K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
227 |
219 |
$24K |
| 76801 |
|
264 |
251 |
$24K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
211 |
199 |
$18K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
177 |
155 |
$12K |
| 76813 |
|
108 |
105 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
70 |
70 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
61 |
58 |
$5K |
| 90715 |
|
53 |
31 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
60 |
52 |
$891.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
35 |
31 |
$718.71 |
| 81025 |
|
95 |
94 |
$622.85 |
| 90686 |
|
20 |
12 |
$322.94 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
13 |
$166.66 |
| 99000 |
|
13 |
13 |
$41.05 |
| 59430 |
|
13 |
13 |
$0.11 |