| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,167 |
9,369 |
$393K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
171 |
151 |
$214K |
| 76830 |
Ultrasound, transvaginal |
1,943 |
1,728 |
$108K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,039 |
1,444 |
$107K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,932 |
1,497 |
$93K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,473 |
1,184 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,655 |
1,285 |
$87K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
938 |
804 |
$70K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
960 |
748 |
$53K |
| 59025 |
Fetal non-stress test |
1,657 |
1,045 |
$39K |
| 59430 |
|
611 |
470 |
$25K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
396 |
264 |
$20K |
| 0503F |
|
1,348 |
1,037 |
$18K |
| 81025 |
|
3,287 |
2,496 |
$12K |
| 81002 |
|
14,316 |
8,916 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
599 |
512 |
$7K |
| 54150 |
|
31 |
29 |
$5K |
| 0500F |
|
359 |
232 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
112 |
98 |
$2K |
| 76820 |
|
55 |
38 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
37 |
32 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
14 |
$591.67 |
| 90674 |
|
14 |
14 |
$332.87 |
| 99459 |
|
14 |
14 |
$228.60 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
25 |
$187.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
16 |
$134.19 |
| 81003 |
|
169 |
79 |
$81.42 |
| 3511F |
|
932 |
682 |
$0.00 |
| 0502F |
|
10,952 |
6,390 |
$0.00 |
| 3513F |
|
794 |
592 |
$0.00 |
| 3293F |
|
888 |
658 |
$0.00 |
| 0501F |
|
1,034 |
872 |
$0.00 |
| 3512F |
|
991 |
762 |
$0.00 |
| 3294F |
|
276 |
235 |
$0.00 |
| 3514F |
|
373 |
283 |
$0.00 |
| 3292F |
|
1,108 |
848 |
$0.00 |
| 99024 |
|
28 |
25 |
$0.00 |