| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
242 |
229 |
$517K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,757 |
6,470 |
$184K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,468 |
1,406 |
$120K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,148 |
1,146 |
$105K |
| 59025 |
Fetal non-stress test |
1,912 |
525 |
$94K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,748 |
1,512 |
$91K |
| 59430 |
|
323 |
313 |
$66K |
| 76830 |
Ultrasound, transvaginal |
1,158 |
1,143 |
$65K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
522 |
514 |
$41K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
681 |
654 |
$39K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
260 |
260 |
$25K |
| 59510 |
|
12 |
12 |
$24K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
25 |
25 |
$19K |
| 81025 |
|
2,016 |
1,921 |
$16K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
167 |
161 |
$13K |
| 59425 |
|
26 |
25 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
706 |
605 |
$12K |
| 59426 |
|
13 |
12 |
$9K |
| 99215 |
Prolong outpt/office vis |
42 |
40 |
$4K |
| 58300 |
|
42 |
42 |
$3K |
| 81002 |
|
1,005 |
987 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
29 |
29 |
$2K |