| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,143 |
3,180 |
$223K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
138 |
114 |
$134K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
719 |
599 |
$59K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
526 |
454 |
$42K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
225 |
189 |
$28K |
| 76830 |
Ultrasound, transvaginal |
263 |
251 |
$19K |
| 99385 |
|
135 |
121 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
125 |
121 |
$13K |
| 76818 |
|
164 |
52 |
$12K |
| A4550 |
Surgical trays |
258 |
186 |
$10K |
| 76801 |
|
116 |
109 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
2,906 |
2,359 |
$8K |
| 81025 |
|
1,157 |
916 |
$8K |
| 59425 |
|
16 |
16 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
68 |
65 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
57 |
45 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
267 |
202 |
$4K |
| 76813 |
|
32 |
32 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
51 |
49 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
177 |
162 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
131 |
107 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
72 |
54 |
$2K |
| 99000 |
|
709 |
574 |
$2K |
| 58300 |
|
36 |
30 |
$1K |
| 59025 |
Fetal non-stress test |
39 |
31 |
$1K |
| 58301 |
|
13 |
12 |
$1K |
| 90715 |
|
26 |
25 |
$964.26 |
| 81002 |
|
282 |
238 |
$810.00 |
| 90756 |
|
12 |
12 |
$242.84 |
| 36416 |
|
44 |
44 |
$136.40 |
| 36410 |
|
18 |
16 |
$110.24 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
56 |
43 |
$0.00 |