| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
7,190 |
3,092 |
$647K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,190 |
3,935 |
$365K |
| 59425 |
|
3,513 |
2,440 |
$283K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,837 |
1,520 |
$139K |
| 59410 |
|
189 |
170 |
$131K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,229 |
1,798 |
$105K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,141 |
1,059 |
$93K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,532 |
1,363 |
$78K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
861 |
743 |
$76K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,394 |
533 |
$70K |
| 76801 |
|
645 |
528 |
$43K |
| 76830 |
Ultrasound, transvaginal |
200 |
177 |
$15K |
| 90686 |
|
1,167 |
689 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
109 |
70 |
$6K |
| 90715 |
|
346 |
222 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
52 |
40 |
$2K |
| 99234 |
|
32 |
28 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
58 |
54 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
164 |
141 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
211 |
113 |
$1K |
| 59025 |
Fetal non-stress test |
31 |
27 |
$460.94 |
| 90674 |
|
14 |
14 |
$288.60 |
| 81025 |
|
44 |
38 |
$276.42 |
| 81002 |
|
43 |
41 |
$71.99 |
| 36415 |
Collection of venous blood by venipuncture |
16 |
12 |
$10.86 |
| 0500F |
|
353 |
289 |
$0.00 |
| 3008F |
|
349 |
320 |
$0.00 |
| 3351F |
|
319 |
292 |
$0.00 |
| 0502F |
|
6,140 |
2,958 |
$0.00 |