| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,968 |
19,060 |
$1.40M |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
722 |
657 |
$986K |
| 99199 |
Unlisted special service, procedure or report |
70,247 |
40,691 |
$459K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,715 |
3,113 |
$288K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,175 |
2,348 |
$229K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,722 |
1,554 |
$180K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,576 |
1,135 |
$165K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,815 |
1,442 |
$157K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
225 |
219 |
$144K |
| 59025 |
Fetal non-stress test |
5,862 |
3,670 |
$137K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
2,796 |
2,218 |
$111K |
| 76801 |
|
973 |
811 |
$88K |
| 81025 |
|
9,059 |
6,789 |
$56K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
776 |
647 |
$56K |
| 76830 |
Ultrasound, transvaginal |
562 |
471 |
$38K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,929 |
1,519 |
$32K |
| 76818 |
|
376 |
224 |
$31K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
384 |
319 |
$26K |
| 90715 |
|
782 |
648 |
$26K |
| 59514 |
|
130 |
103 |
$24K |
| 99058 |
|
1,613 |
1,232 |
$19K |
| 81002 |
|
7,331 |
4,511 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
564 |
436 |
$16K |
| 81003 |
|
5,845 |
4,386 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
160 |
117 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
800 |
669 |
$9K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
170 |
156 |
$8K |
| 99215 |
Prolong outpt/office vis |
42 |
41 |
$6K |
| 99401 |
|
210 |
134 |
$5K |
| 96127 |
|
1,297 |
938 |
$4K |
| 59430 |
|
31 |
30 |
$3K |
| 99205 |
Prolong outpt/office vis |
13 |
13 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
13 |
$538.90 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
34 |
28 |
$504.43 |
| 87210 |
|
77 |
56 |
$225.60 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
21 |
14 |
$0.37 |
| 0502F |
|
10,445 |
6,906 |
$0.00 |
| 0500F |
|
482 |
368 |
$0.00 |
| 0503F |
|
29 |
24 |
$0.00 |
| 99000 |
|
1,206 |
961 |
$0.00 |
| 99024 |
|
15 |
14 |
$0.00 |