| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,593 |
2,179 |
$109K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
58 |
48 |
$73K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
698 |
498 |
$58K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
792 |
768 |
$30K |
| 59025 |
Fetal non-stress test |
753 |
302 |
$26K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
641 |
631 |
$22K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
112 |
110 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
374 |
347 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
113 |
52 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
334 |
302 |
$5K |
| 90686 |
|
188 |
168 |
$3K |
| 90715 |
|
59 |
58 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
52 |
50 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$974.80 |
| 87210 |
|
210 |
189 |
$515.85 |