| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
776 |
611 |
$863K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,749 |
1,672 |
$113K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,490 |
3,501 |
$101K |
| 99215 |
Prolong outpt/office vis |
1,364 |
867 |
$76K |
| 59510 |
|
88 |
40 |
$70K |
| 99205 |
Prolong outpt/office vis |
889 |
553 |
$66K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,455 |
1,181 |
$46K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
325 |
258 |
$24K |
| 81025 |
|
5,333 |
3,301 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,130 |
658 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
313 |
187 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
739 |
606 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
181 |
92 |
$9K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
189 |
107 |
$7K |
| 0500F |
|
3,536 |
2,086 |
$6K |
| 87210 |
|
3,042 |
1,780 |
$6K |
| 76830 |
Ultrasound, transvaginal |
87 |
75 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
113 |
80 |
$3K |
| 76801 |
|
39 |
38 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
16 |
13 |
$679.68 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
22 |
13 |
$576.25 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$556.53 |
| 3008F |
|
814 |
475 |
$470.00 |
| 59430 |
|
77 |
71 |
$467.82 |
| 0503F |
|
652 |
559 |
$320.83 |
| 3074F |
|
36 |
28 |
$10.00 |
| H0049 |
Alcohol and/or drug screening |
1,458 |
811 |
$0.00 |
| 0501F |
|
996 |
879 |
$0.00 |
| 99024 |
|
14 |
14 |
$0.00 |
| 0502F |
|
12,484 |
7,322 |
$0.00 |
| 99408 |
|
31 |
17 |
$0.00 |