| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
431 |
371 |
$478K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,003 |
1,513 |
$170K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,769 |
2,223 |
$136K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,176 |
1,770 |
$113K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,323 |
1,135 |
$104K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,368 |
1,927 |
$82K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,459 |
1,122 |
$74K |
| 59430 |
|
916 |
672 |
$57K |
| 0503F |
|
1,931 |
1,412 |
$46K |
| 76830 |
Ultrasound, transvaginal |
676 |
572 |
$38K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
590 |
519 |
$36K |
| 76820 |
|
483 |
275 |
$24K |
| 90715 |
|
565 |
505 |
$24K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
374 |
307 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
331 |
272 |
$20K |
| 59410 |
|
26 |
25 |
$20K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
313 |
230 |
$18K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,256 |
1,060 |
$17K |
| 76801 |
|
244 |
203 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
186 |
152 |
$15K |
| 81025 |
|
2,560 |
2,108 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
252 |
194 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
618 |
544 |
$5K |
| 81003 |
|
1,826 |
1,133 |
$3K |
| 0500F |
|
383 |
286 |
$3K |
| 81002 |
|
1,094 |
903 |
$2K |
| 99385 |
|
28 |
24 |
$2K |
| 96160 |
|
49 |
46 |
$1K |
| 59025 |
Fetal non-stress test |
35 |
17 |
$819.80 |
| 87210 |
|
175 |
146 |
$573.81 |
| 85018 |
|
57 |
49 |
$115.99 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
212 |
201 |
$69.23 |
| 0502F |
|
10,972 |
6,248 |
$16.00 |
| 99080 |
|
1,101 |
686 |
$0.00 |
| 3513F |
|
38 |
24 |
$0.00 |
| 3493F |
|
43 |
25 |
$0.00 |
| 3511F |
|
16 |
12 |
$0.00 |
| 0501F |
|
1,991 |
1,233 |
$0.00 |
| 3291F |
|
19 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
16 |
14 |
$0.00 |