| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
12,596 |
6,993 |
$1.05M |
| 59425 |
|
7,391 |
6,581 |
$570K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,322 |
6,713 |
$388K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,012 |
1,848 |
$149K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,078 |
476 |
$74K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
891 |
846 |
$62K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
176 |
162 |
$55K |
| 81025 |
|
6,967 |
6,350 |
$46K |
| 76830 |
Ultrasound, transvaginal |
724 |
677 |
$42K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
590 |
529 |
$38K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
585 |
557 |
$28K |
| 76801 |
|
380 |
346 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
397 |
363 |
$17K |
| 81002 |
|
6,407 |
4,513 |
$17K |
| 59430 |
|
167 |
157 |
$13K |
| 59025 |
Fetal non-stress test |
152 |
101 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
29 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
74 |
65 |
$760.40 |
| 87210 |
|
457 |
433 |
$759.81 |
| 90686 |
|
69 |
68 |
$265.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
69 |
68 |
$229.14 |
| 99354 |
|
48 |
44 |
$120.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
55 |
50 |
$13.21 |
| 99385 |
|
40 |
38 |
$0.00 |
| 0501F |
|
24 |
24 |
$0.00 |
| 4004F |
|
582 |
349 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
40 |
40 |
$0.00 |