| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
234 |
182 |
$274K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,671 |
5,633 |
$224K |
| 76830 |
Ultrasound, transvaginal |
1,269 |
1,079 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,345 |
1,255 |
$86K |
| 59426 |
|
96 |
81 |
$59K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
608 |
591 |
$54K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
806 |
751 |
$41K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
274 |
261 |
$16K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
35 |
25 |
$16K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
282 |
277 |
$10K |
| 81025 |
|
1,381 |
1,275 |
$9K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
199 |
199 |
$6K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
197 |
171 |
$6K |
| 76801 |
|
85 |
79 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
63 |
$6K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
88 |
82 |
$5K |
| 58300 |
|
48 |
38 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
26 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
27 |
24 |
$2K |
| 76998 |
|
25 |
25 |
$1K |
| 76857 |
|
44 |
38 |
$1K |
| 90715 |
|
33 |
26 |
$607.04 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
24 |
$365.73 |
| 76820 |
|
18 |
15 |
$0.00 |
| 93976 |
|
129 |
118 |
$0.00 |