| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
323 |
271 |
$295K |
| 0502F |
|
4,335 |
2,950 |
$210K |
| 76830 |
Ultrasound, transvaginal |
2,087 |
1,693 |
$110K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,646 |
1,320 |
$103K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,255 |
980 |
$69K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,406 |
1,152 |
$55K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,050 |
867 |
$54K |
| 76801 |
|
909 |
767 |
$49K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,039 |
795 |
$45K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,027 |
789 |
$44K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
695 |
528 |
$38K |
| 87481 |
|
527 |
352 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
365 |
309 |
$26K |
| 87511 |
|
491 |
352 |
$22K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
730 |
557 |
$20K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
277 |
230 |
$20K |
| 76818 |
|
387 |
211 |
$20K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
422 |
268 |
$17K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
306 |
262 |
$10K |
| 76857 |
|
170 |
138 |
$9K |
| 0500F |
|
139 |
129 |
$6K |
| 86780 |
|
276 |
230 |
$5K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
157 |
122 |
$4K |
| 86803 |
|
144 |
119 |
$2K |
| 87653 |
|
49 |
40 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
25 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
34 |
30 |
$2K |
| 81025 |
|
560 |
477 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
270 |
226 |
$2K |
| 87340 |
|
112 |
93 |
$2K |
| T1015 |
Clinic visit/encounter, all-inclusive |
33 |
16 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
29 |
25 |
$1K |
| 81513 |
|
12 |
12 |
$981.16 |
| 0503F |
|
22 |
17 |
$952.85 |
| 59025 |
Fetal non-stress test |
30 |
24 |
$717.70 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
17 |
12 |
$713.97 |
| 96160 |
|
31 |
24 |
$428.76 |
| 86762 |
|
42 |
37 |
$362.03 |
| 84443 |
Thyroid stimulating hormone (TSH) |
15 |
13 |
$246.30 |
| 96127 |
|
16 |
12 |
$218.43 |
| 82950 |
|
33 |
31 |
$153.55 |
| 84702 |
|
13 |
12 |
$107.91 |