| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
215 |
157 |
$235K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,475 |
1,298 |
$104K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,436 |
1,944 |
$95K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,492 |
1,096 |
$76K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
586 |
474 |
$58K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
971 |
814 |
$56K |
| 59025 |
Fetal non-stress test |
1,754 |
853 |
$55K |
| 76818 |
|
763 |
311 |
$51K |
| 76801 |
|
580 |
514 |
$35K |
| 57452 |
|
494 |
453 |
$34K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,235 |
1,037 |
$31K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,557 |
1,356 |
$22K |
| 90715 |
|
366 |
344 |
$14K |
| 0500F |
|
702 |
625 |
$6K |
| 81025 |
|
1,305 |
1,149 |
$5K |
| 99385 |
|
63 |
55 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
98 |
44 |
$3K |
| 87210 |
|
1,335 |
1,120 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
40 |
37 |
$3K |
| 81002 |
|
1,175 |
1,050 |
$2K |
| 90686 |
|
87 |
81 |
$1K |
| 0503F |
|
312 |
265 |
$1K |
| 0502F |
|
2,690 |
1,400 |
$982.18 |
| 59430 |
|
93 |
66 |
$481.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
47 |
45 |
$395.56 |
| 99024 |
|
345 |
288 |
$0.00 |