| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
8,547 |
5,790 |
$517K |
| 59426 |
|
4,337 |
1,911 |
$234K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,839 |
3,191 |
$158K |
| 81002 |
|
20,526 |
11,522 |
$49K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
926 |
771 |
$28K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
319 |
230 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
845 |
693 |
$21K |
| 51701 |
|
403 |
281 |
$9K |
| 76830 |
Ultrasound, transvaginal |
535 |
488 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
286 |
271 |
$3K |
| 59514 |
|
95 |
54 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
365 |
269 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
147 |
93 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
70 |
60 |
$1K |
| 99218 |
|
15 |
13 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
385 |
350 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
376 |
168 |
$1K |
| 99354 |
|
280 |
138 |
$960.00 |
| 90688 |
|
130 |
109 |
$910.57 |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
83 |
53 |
$850.00 |
| 59430 |
|
279 |
161 |
$699.58 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
215 |
180 |
$529.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
240 |
192 |
$471.91 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
15 |
14 |
$354.73 |
| 99215 |
Prolong outpt/office vis |
162 |
109 |
$206.36 |
| 58301 |
|
35 |
24 |
$134.12 |
| 99219 |
|
32 |
28 |
$131.26 |
| 59025 |
Fetal non-stress test |
323 |
122 |
$113.22 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
239 |
189 |
$92.70 |
| 76801 |
|
299 |
189 |
$90.18 |
| 90715 |
|
114 |
84 |
$77.27 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
174 |
154 |
$76.71 |
| 81025 |
|
155 |
129 |
$38.74 |
| 87210 |
|
184 |
148 |
$5.13 |
| 58300 |
|
135 |
108 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
49 |
25 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
13 |
$0.00 |