| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,919 |
10,378 |
$547K |
| 76830 |
Ultrasound, transvaginal |
2,186 |
2,150 |
$207K |
| 59025 |
Fetal non-stress test |
3,670 |
1,765 |
$135K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,475 |
1,341 |
$98K |
| 59514 |
|
72 |
70 |
$46K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
603 |
591 |
$43K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
374 |
370 |
$38K |
| 59430 |
|
399 |
335 |
$35K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
423 |
417 |
$30K |
| 81025 |
|
4,230 |
3,798 |
$29K |
| 81003 |
|
15,123 |
9,707 |
$28K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
304 |
303 |
$27K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
400 |
393 |
$26K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
222 |
218 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$7K |
| 87084 |
|
166 |
154 |
$3K |
| 99217 |
|
41 |
39 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
185 |
178 |
$2K |
| 99218 |
|
42 |
40 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
96 |
92 |
$788.02 |
| 99221 |
|
13 |
12 |
$685.16 |
| 84443 |
Thyroid stimulating hormone (TSH) |
24 |
24 |
$464.64 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
618 |
565 |
$228.06 |
| 87320 |
|
13 |
13 |
$179.53 |