| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
1,531 |
1,531 |
$556K |
| 59514 |
|
398 |
397 |
$152K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,174 |
4,391 |
$104K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,329 |
2,324 |
$70K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,261 |
2,138 |
$65K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,690 |
1,649 |
$57K |
| 76830 |
Ultrasound, transvaginal |
1,243 |
1,219 |
$37K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
907 |
905 |
$37K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,216 |
1,190 |
$35K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
61 |
61 |
$18K |
| 58300 |
|
252 |
161 |
$17K |
| 58301 |
|
142 |
70 |
$9K |
| 11981 |
|
88 |
49 |
$7K |
| J7301 |
Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg |
86 |
86 |
$2K |
| 59425 |
|
43 |
25 |
$1K |
| Z1034 |
|
23 |
14 |
$1K |
| 96156 |
|
369 |
301 |
$1K |
| 97803 |
|
330 |
268 |
$1K |
| 99401 |
|
265 |
223 |
$837.70 |
| 81025 |
|
1,068 |
1,050 |
$715.71 |
| 99403 |
|
18 |
14 |
$53.83 |
| 99442 |
|
24 |
23 |
$37.72 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$37.50 |
| 0502F |
|
87 |
63 |
$0.00 |