| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,346 |
4,087 |
$200K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,305 |
2,303 |
$187K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
152 |
149 |
$115K |
| 59426 |
|
136 |
136 |
$107K |
| 59430 |
|
267 |
267 |
$53K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
445 |
445 |
$41K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
416 |
416 |
$33K |
| 59025 |
Fetal non-stress test |
1,035 |
287 |
$28K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
176 |
176 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
245 |
243 |
$16K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
224 |
213 |
$15K |
| 76830 |
Ultrasound, transvaginal |
212 |
212 |
$14K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
62 |
62 |
$4K |
| 54150 |
|
51 |
51 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
179 |
154 |
$2K |
| 58300 |
|
24 |
24 |
$993.08 |
| 76801 |
|
12 |
12 |
$836.76 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
38 |
38 |
$0.00 |