| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,184 |
1,098 |
$134K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
898 |
745 |
$53K |
| 59025 |
Fetal non-stress test |
1,100 |
765 |
$39K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
364 |
319 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
316 |
250 |
$23K |
| 99460 |
|
257 |
246 |
$22K |
| 76830 |
Ultrasound, transvaginal |
202 |
166 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,177 |
1,031 |
$19K |
| 76801 |
|
214 |
194 |
$16K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
218 |
208 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
112 |
98 |
$9K |
| 99461 |
|
113 |
95 |
$7K |
| 99215 |
Prolong outpt/office vis |
70 |
51 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
44 |
39 |
$3K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
81 |
73 |
$3K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
16 |
15 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
69 |
64 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
50 |
27 |
$3K |
| 81025 |
|
548 |
438 |
$2K |
| 3078F |
|
3,226 |
3,011 |
$2K |
| 81002 |
|
982 |
938 |
$2K |
| 3074F |
|
3,426 |
3,198 |
$1K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
14 |
13 |
$571.24 |
| 90715 |
|
250 |
223 |
$525.39 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
25 |
25 |
$501.61 |
| 82962 |
|
405 |
250 |
$345.13 |
| 90686 |
|
347 |
293 |
$83.83 |
| 90656 |
|
46 |
45 |
$22.35 |
| 0502F |
|
1,842 |
1,583 |
$0.00 |
| 0500F |
|
366 |
362 |
$0.00 |
| 99024 |
|
57 |
55 |
$0.00 |
| 0503F |
|
12 |
12 |
$0.00 |