| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
1,897 |
1,873 |
$1.41M |
| 59426 |
|
1,560 |
1,542 |
$1.32M |
| 59514 |
|
1,389 |
1,018 |
$749K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,808 |
9,641 |
$512K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
2,326 |
1,339 |
$448K |
| 59430 |
|
1,794 |
1,781 |
$362K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,276 |
3,926 |
$292K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,647 |
3,388 |
$188K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
187 |
186 |
$169K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,773 |
2,732 |
$165K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,040 |
2,031 |
$163K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,173 |
2,086 |
$139K |
| 76830 |
Ultrasound, transvaginal |
1,892 |
1,812 |
$128K |
| 59425 |
|
246 |
234 |
$108K |
| 59025 |
Fetal non-stress test |
2,509 |
1,191 |
$67K |
| 90715 |
|
1,971 |
1,956 |
$64K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
798 |
790 |
$58K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
711 |
706 |
$56K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
497 |
479 |
$48K |
| 58300 |
|
672 |
664 |
$34K |
| 80305 |
|
3,137 |
2,744 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,622 |
2,575 |
$26K |
| 99406 |
|
3,404 |
2,897 |
$21K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
490 |
490 |
$19K |
| 90756 |
|
528 |
524 |
$14K |
| 81025 |
|
1,865 |
1,821 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,403 |
1,321 |
$11K |
| 90678 |
|
25 |
25 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
147 |
110 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
136 |
129 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
36 |
36 |
$3K |
| 58301 |
|
53 |
53 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
30 |
27 |
$3K |
| 76857 |
|
64 |
64 |
$2K |
| 90661 |
|
46 |
46 |
$2K |
| 57454 |
|
14 |
14 |
$1K |
| 99408 |
|
67 |
67 |
$1K |
| 76820 |
|
47 |
25 |
$1K |
| 90658 |
|
85 |
85 |
$1K |
| 96127 |
|
375 |
362 |
$1K |
| 99459 |
|
66 |
62 |
$622.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$192.70 |
| 0502F |
|
2,922 |
1,236 |
$0.00 |