| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
88 |
79 |
$215K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,507 |
941 |
$165K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,882 |
5,828 |
$131K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,399 |
1,291 |
$122K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
193 |
182 |
$16K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
230 |
200 |
$13K |
| 76801 |
|
135 |
130 |
$12K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
89 |
86 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
84 |
82 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
70 |
68 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
63 |
58 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
48 |
48 |
$4K |
| 76813 |
|
26 |
26 |
$2K |
| 90715 |
|
47 |
47 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
52 |
50 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24 |
22 |
$645.46 |
| 90686 |
|
33 |
33 |
$557.79 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27 |
25 |
$469.61 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
30 |
29 |
$312.62 |
| 81025 |
|
29 |
26 |
$185.63 |
| 59430 |
|
15 |
15 |
$0.15 |
| 99000 |
|
122 |
118 |
$0.00 |