| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,249 |
4,061 |
$191K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,515 |
2,343 |
$156K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
80 |
79 |
$151K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
163 |
162 |
$150K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,068 |
1,929 |
$134K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,688 |
1,673 |
$132K |
| 59426 |
|
149 |
148 |
$132K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,520 |
1,513 |
$121K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,173 |
1,138 |
$85K |
| 76830 |
Ultrasound, transvaginal |
952 |
917 |
$65K |
| 59025 |
Fetal non-stress test |
2,297 |
1,117 |
$61K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,993 |
1,769 |
$53K |
| 90715 |
|
1,151 |
1,147 |
$37K |
| 58300 |
|
658 |
642 |
$33K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
747 |
714 |
$32K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
551 |
475 |
$30K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
389 |
387 |
$23K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
30 |
30 |
$23K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,721 |
1,697 |
$22K |
| 59430 |
|
96 |
95 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,974 |
1,921 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,027 |
1,709 |
$17K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
184 |
182 |
$16K |
| 54150 |
|
258 |
256 |
$14K |
| 90678 |
|
34 |
34 |
$10K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
362 |
211 |
$8K |
| 81025 |
|
1,129 |
1,098 |
$7K |
| 90686 |
|
367 |
365 |
$7K |
| 87210 |
|
1,230 |
820 |
$5K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
179 |
179 |
$4K |
| 81002 |
|
1,489 |
1,307 |
$3K |
| 80305 |
|
336 |
332 |
$3K |
| 90688 |
|
162 |
159 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$2K |
| 58301 |
|
37 |
37 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$984.12 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$403.80 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
27 |
$337.54 |
| 90656 |
|
15 |
15 |
$312.90 |
| 83986 |
|
25 |
25 |
$56.13 |
| 0502F |
|
148 |
89 |
$0.00 |