| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
1,463 |
1,354 |
$1.72M |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,855 |
2,672 |
$225K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,783 |
2,381 |
$200K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
4,120 |
3,286 |
$198K |
| 76830 |
Ultrasound, transvaginal |
2,395 |
2,187 |
$142K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,734 |
3,171 |
$113K |
| 0503F |
|
1,973 |
1,630 |
$51K |
| 90715 |
|
1,102 |
999 |
$50K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
700 |
637 |
$48K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
755 |
678 |
$44K |
| 96160 |
|
2,251 |
1,865 |
$43K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
874 |
732 |
$41K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
475 |
435 |
$28K |
| 0500F |
|
2,273 |
1,947 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
368 |
317 |
$20K |
| 59430 |
|
1,191 |
949 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,790 |
1,477 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,580 |
1,413 |
$12K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
12 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
137 |
119 |
$7K |
| 81025 |
|
1,082 |
954 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
266 |
226 |
$4K |
| 76820 |
|
60 |
41 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
17 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
86 |
76 |
$1K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
12 |
12 |
$1K |
| 90656 |
|
47 |
44 |
$933.26 |
| 90688 |
|
45 |
45 |
$891.79 |
| 0502F |
|
5,914 |
4,750 |
$886.01 |
| 76801 |
|
16 |
13 |
$884.26 |
| 0501F |
|
3,455 |
2,971 |
$880.14 |
| 90674 |
|
27 |
20 |
$808.03 |
| 58300 |
|
15 |
12 |
$765.74 |
| 81001 |
|
230 |
210 |
$529.72 |
| 81003 |
|
791 |
670 |
$500.32 |
| 99406 |
|
50 |
43 |
$364.11 |
| 90658 |
|
18 |
18 |
$292.34 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$69.92 |