| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
1,015 |
1,004 |
$769K |
| 59426 |
|
303 |
303 |
$262K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,145 |
3,777 |
$231K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
3,394 |
3,313 |
$186K |
| 59025 |
Fetal non-stress test |
7,616 |
2,688 |
$150K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,518 |
4,089 |
$147K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,436 |
3,323 |
$144K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,448 |
1,445 |
$111K |
| 76801 |
|
2,256 |
2,151 |
$94K |
| 59430 |
|
337 |
334 |
$69K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
686 |
685 |
$53K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
691 |
645 |
$30K |
| 76820 |
|
1,949 |
1,431 |
$29K |
| 99385 |
|
202 |
201 |
$19K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
165 |
165 |
$15K |
| 54150 |
|
274 |
274 |
$15K |
| 76813 |
|
278 |
277 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
168 |
168 |
$8K |
| 76830 |
Ultrasound, transvaginal |
105 |
105 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
273 |
246 |
$6K |
| 81025 |
|
863 |
836 |
$6K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
216 |
216 |
$6K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
92 |
92 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
294 |
288 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
133 |
108 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
291 |
275 |
$3K |
| 99386 |
|
13 |
13 |
$1K |
| 90686 |
|
56 |
56 |
$972.60 |
| 96127 |
|
134 |
128 |
$375.21 |
| 90715 |
|
12 |
12 |
$364.08 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
16 |
15 |
$76.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
31 |
31 |
$6.70 |
| 0502F |
|
264 |
178 |
$0.00 |
| 3078F |
|
15 |
15 |
$0.00 |
| 3074F |
|
16 |
16 |
$0.00 |