| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
6,126 |
2,363 |
$518K |
| 59425 |
|
4,886 |
3,455 |
$366K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,532 |
2,941 |
$209K |
| 59025 |
Fetal non-stress test |
5,282 |
1,800 |
$195K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,626 |
1,464 |
$139K |
| 59430 |
|
631 |
524 |
$101K |
| 76830 |
Ultrasound, transvaginal |
510 |
474 |
$45K |
| 81002 |
|
17,179 |
10,320 |
$40K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
111 |
77 |
$38K |
| 76801 |
|
440 |
397 |
$38K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
296 |
197 |
$25K |
| 81025 |
|
3,299 |
2,924 |
$22K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
370 |
343 |
$22K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
288 |
251 |
$18K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
422 |
272 |
$18K |
| 80305 |
|
1,690 |
1,416 |
$16K |
| 99354 |
|
287 |
223 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,302 |
855 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
644 |
518 |
$8K |
| 90715 |
|
234 |
200 |
$6K |
| 90674 |
|
83 |
65 |
$2K |
| 99000 |
|
1,220 |
789 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,099 |
766 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$1K |
| 90756 |
|
39 |
38 |
$864.27 |
| G9997 |
Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter |
12 |
12 |
$720.00 |
| 90686 |
|
30 |
16 |
$321.75 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
18 |
12 |
$0.00 |
| 90656 |
|
21 |
17 |
$0.00 |