| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
154 |
137 |
$177K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
10,887 |
8,755 |
$132K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,040 |
1,798 |
$111K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
7,946 |
6,538 |
$102K |
| 87481 |
|
5,239 |
1,441 |
$96K |
| H1000 |
Prenatal care, at-risk assessment |
881 |
615 |
$67K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,716 |
1,392 |
$62K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,143 |
1,545 |
$59K |
| G9357 |
Post-partum screenings, evaluations and education performed |
717 |
536 |
$58K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,610 |
1,125 |
$54K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,330 |
5,504 |
$47K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,116 |
3,496 |
$29K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,500 |
1,275 |
$24K |
| 54150 |
|
182 |
122 |
$19K |
| 81002 |
|
22,701 |
15,637 |
$15K |
| 81025 |
|
6,195 |
5,231 |
$13K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
192 |
103 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
467 |
351 |
$9K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
200 |
147 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
8,060 |
6,630 |
$5K |
| 87510 |
|
314 |
226 |
$5K |
| 87480 |
|
300 |
214 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
533 |
441 |
$4K |
| 82947 |
|
822 |
782 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,636 |
1,345 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,517 |
1,263 |
$2K |
| 87660 |
|
301 |
226 |
$695.30 |
| 84702 |
|
54 |
43 |
$505.14 |
| 59426 |
|
116 |
114 |
$491.00 |
| 80053 |
Comprehensive metabolic panel |
51 |
50 |
$462.39 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
77 |
67 |
$447.60 |
| 90674 |
|
22 |
18 |
$432.90 |
| 99459 |
|
82 |
65 |
$340.56 |
| 84144 |
|
15 |
12 |
$180.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
30 |
$140.00 |
| 90658 |
|
12 |
12 |
$108.00 |
| 59430 |
|
89 |
83 |
$0.00 |
| 59514 |
|
41 |
37 |
$0.00 |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
15 |
13 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
31 |
27 |
$0.00 |