| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,706 |
4,684 |
$594K |
| 76813 |
|
3,357 |
3,059 |
$439K |
| 76801 |
|
4,033 |
3,964 |
$428K |
| J3490 |
Unclassified drugs |
2,761 |
2,592 |
$423K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,834 |
9,394 |
$420K |
| 59425 |
|
4,369 |
3,418 |
$397K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,524 |
4,259 |
$286K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,304 |
3,245 |
$243K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,816 |
1,743 |
$203K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
5,015 |
4,976 |
$191K |
| Z1034 |
|
3,351 |
2,732 |
$184K |
| 0500F |
|
633 |
632 |
$176K |
| 90651 |
|
675 |
675 |
$174K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
64 |
64 |
$138K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
892 |
889 |
$136K |
| 59025 |
Fetal non-stress test |
4,132 |
2,192 |
$127K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,278 |
1,270 |
$111K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
124 |
124 |
$70K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
4,336 |
4,304 |
$66K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,237 |
1,180 |
$37K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
288 |
249 |
$36K |
| Z6400 |
|
1,441 |
1,439 |
$35K |
| 90715 |
|
915 |
835 |
$33K |
| S0197 |
Prenatal vitamins, 30-day supply |
1,035 |
1,010 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
801 |
608 |
$21K |
| 90674 |
|
661 |
652 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,281 |
2,252 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
168 |
166 |
$19K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
63 |
63 |
$14K |
| 99386 |
|
67 |
67 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
132 |
132 |
$11K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
89 |
63 |
$11K |
| 90656 |
|
310 |
253 |
$7K |
| 59514 |
|
12 |
12 |
$7K |
| 99385 |
|
27 |
27 |
$5K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
72 |
69 |
$5K |
| 81025 |
|
1,472 |
1,461 |
$4K |
| 59430 |
|
92 |
92 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$741.34 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
22 |
12 |
$483.84 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$213.78 |