| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,747 |
3,021 |
$126K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
934 |
807 |
$57K |
| 76801 |
|
694 |
511 |
$32K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
392 |
341 |
$26K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
14 |
12 |
$15K |
| H1000 |
Prenatal care, at-risk assessment |
159 |
118 |
$11K |
| 54150 |
|
51 |
36 |
$6K |
| G9357 |
Post-partum screenings, evaluations and education performed |
51 |
44 |
$4K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
59 |
24 |
$3K |
| 59025 |
Fetal non-stress test |
66 |
52 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
20 |
14 |
$836.00 |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$781.00 |
| 81002 |
|
2,455 |
1,624 |
$621.35 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
16 |
13 |
$545.94 |
| 87210 |
|
142 |
100 |
$516.08 |
| 81025 |
|
156 |
140 |
$459.89 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15 |
12 |
$456.00 |
| 99459 |
|
45 |
32 |
$359.02 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
26 |
25 |
$268.54 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
14 |
$70.00 |
| 81000 |
|
850 |
576 |
$0.00 |
| 85018 |
|
90 |
63 |
$0.00 |
| 59426 |
|
65 |
39 |
$0.00 |