| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,579 |
13,400 |
$649K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,637 |
2,461 |
$132K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,289 |
2,001 |
$120K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
168 |
168 |
$101K |
| 59430 |
|
730 |
663 |
$59K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
389 |
377 |
$30K |
| 76830 |
Ultrasound, transvaginal |
497 |
433 |
$30K |
| 90715 |
|
500 |
491 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
279 |
263 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
190 |
181 |
$10K |
| 59514 |
|
13 |
12 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
805 |
778 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
103 |
102 |
$6K |
| 76801 |
|
120 |
113 |
$6K |
| 76813 |
|
112 |
108 |
$5K |
| 90674 |
|
153 |
152 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
25 |
$1K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
25 |
13 |
$1K |
| 90661 |
|
34 |
32 |
$756.90 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
16 |
15 |
$649.60 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
20 |
12 |
$634.04 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
17 |
14 |
$442.20 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
18 |
15 |
$442.20 |
| 87511 |
|
21 |
13 |
$383.24 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
21 |
13 |
$383.24 |
| 87653 |
|
20 |
13 |
$383.24 |
| 81025 |
|
57 |
51 |
$381.40 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
12 |
$104.32 |
| 96127 |
|
141 |
137 |
$0.00 |