| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,953 |
13,854 |
$715K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
1,350 |
1,310 |
$703K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,853 |
5,279 |
$505K |
| 59514 |
|
540 |
518 |
$318K |
| 59025 |
Fetal non-stress test |
4,606 |
2,394 |
$160K |
| 76830 |
Ultrasound, transvaginal |
1,702 |
1,653 |
$153K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,103 |
2,082 |
$135K |
| 76801 |
|
1,544 |
1,482 |
$134K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,831 |
2,674 |
$124K |
| 59430 |
|
1,323 |
1,308 |
$121K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,430 |
1,415 |
$103K |
| 81002 |
|
33,856 |
23,047 |
$95K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,390 |
1,121 |
$83K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,133 |
1,100 |
$60K |
| 81025 |
|
6,181 |
5,738 |
$43K |
| 90715 |
|
1,478 |
1,456 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
381 |
372 |
$27K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,198 |
1,923 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,779 |
1,725 |
$17K |
| 99385 |
|
140 |
139 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
79 |
73 |
$8K |
| 90756 |
|
207 |
204 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
326 |
308 |
$3K |
| 11981 |
|
26 |
25 |
$2K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
25 |
25 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
25 |
$1K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
26 |
25 |
$839.58 |
| 87210 |
|
121 |
118 |
$526.98 |
| 90661 |
|
21 |
21 |
$312.42 |
| CP002 |
|
47 |
40 |
$219.80 |
| 85018 |
|
39 |
38 |
$73.36 |