| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,196 |
8,484 |
$755K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,935 |
3,341 |
$326K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
217 |
209 |
$201K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,247 |
1,150 |
$88K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
562 |
510 |
$75K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
892 |
668 |
$61K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
682 |
587 |
$52K |
| 59025 |
Fetal non-stress test |
1,671 |
831 |
$45K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
274 |
234 |
$32K |
| 59430 |
|
197 |
193 |
$26K |
| 81025 |
|
2,567 |
2,144 |
$18K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
645 |
519 |
$12K |
| 36415 |
Collection of venous blood by venipuncture |
5,052 |
4,074 |
$11K |
| 87210 |
|
2,236 |
1,898 |
$10K |
| 83986 |
|
2,241 |
1,905 |
$7K |
| 81002 |
|
2,210 |
2,017 |
$6K |
| 81000 |
|
1,861 |
1,600 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,992 |
1,685 |
$6K |
| 90715 |
|
129 |
126 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
139 |
113 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
414 |
376 |
$3K |
| 90658 |
|
235 |
216 |
$3K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
15 |
14 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
63 |
49 |
$931.02 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
12 |
$835.70 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
30 |
24 |
$358.30 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
12 |
$32.23 |