| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,266 |
2,613 |
$119K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,621 |
732 |
$55K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,572 |
1,253 |
$51K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
553 |
477 |
$34K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
731 |
571 |
$25K |
| 76830 |
Ultrasound, transvaginal |
418 |
342 |
$19K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
13 |
12 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
272 |
236 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
196 |
177 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
773 |
661 |
$9K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
114 |
107 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
188 |
154 |
$7K |
| 81025 |
|
1,587 |
1,366 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
377 |
332 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
74 |
67 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
193 |
184 |
$2K |
| 76801 |
|
30 |
28 |
$1K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
15 |
13 |
$1K |
| 90715 |
|
14 |
14 |
$660.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
30 |
$277.69 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
32 |
30 |
$174.88 |
| 81003 |
|
31 |
29 |
$40.05 |
| 0500F |
|
67 |
53 |
$0.00 |
| 99024 |
|
436 |
395 |
$0.00 |
| 0501F |
|
67 |
53 |
$0.00 |
| 0502F |
|
67 |
53 |
$0.00 |
| 99080 |
|
116 |
81 |
$0.00 |