| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
1,666 |
1,302 |
$1.88M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,407 |
6,289 |
$358K |
| 59510 |
|
248 |
181 |
$242K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,487 |
1,240 |
$160K |
| 76830 |
Ultrasound, transvaginal |
1,714 |
1,290 |
$106K |
| 99199 |
Unlisted special service, procedure or report |
20,459 |
19,494 |
$68K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,494 |
1,072 |
$50K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,561 |
1,268 |
$41K |
| 59025 |
Fetal non-stress test |
2,277 |
1,212 |
$37K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
340 |
236 |
$33K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
487 |
446 |
$29K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,256 |
1,720 |
$29K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
374 |
288 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
413 |
266 |
$21K |
| 81025 |
|
2,888 |
2,381 |
$17K |
| 81003 |
|
7,452 |
4,347 |
$3K |
| 81002 |
|
1,481 |
1,288 |
$3K |
| 11981 |
|
17 |
15 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
13 |
$305.49 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
127 |
110 |
$0.64 |
| 99024 |
|
20,534 |
14,716 |
$0.00 |
| 0503F |
|
329 |
259 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
7,951 |
4,978 |
$0.00 |