| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
1,875 |
1,621 |
$2.37M |
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
2,413 |
1,263 |
$450K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
8,578 |
6,513 |
$449K |
| 93976 |
|
3,357 |
1,721 |
$432K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,989 |
2,472 |
$374K |
| 76818 |
|
3,290 |
1,697 |
$234K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,686 |
4,559 |
$202K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,161 |
3,162 |
$192K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,905 |
1,847 |
$155K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,711 |
1,424 |
$123K |
| 59025 |
Fetal non-stress test |
3,563 |
2,429 |
$100K |
| 59510 |
|
70 |
54 |
$80K |
| 90715 |
|
1,943 |
1,720 |
$76K |
| H0033 |
Oral medication administration, direct observation |
501 |
320 |
$76K |
| 76830 |
Ultrasound, transvaginal |
1,302 |
1,102 |
$72K |
| 76801 |
|
654 |
532 |
$41K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
483 |
409 |
$35K |
| 81025 |
|
6,846 |
5,231 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,833 |
2,442 |
$25K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,756 |
1,364 |
$24K |
| 59426 |
|
43 |
38 |
$20K |
| 90686 |
|
875 |
724 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
168 |
136 |
$14K |
| 90832 |
Psychotherapy, 30 minutes with patient |
415 |
224 |
$8K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
1,202 |
925 |
$6K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,196 |
926 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
211 |
176 |
$5K |
| 59425 |
|
14 |
12 |
$4K |
| 80305 |
|
408 |
261 |
$3K |
| H2010 |
Comprehensive medication services, per 15 minutes |
24 |
12 |
$2K |
| 0500F |
|
2,154 |
1,741 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
18 |
12 |
$999.91 |
| 90656 |
|
53 |
53 |
$940.00 |
| 99385 |
|
15 |
12 |
$853.26 |
| 81002 |
|
453 |
379 |
$769.28 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
44 |
33 |
$220.22 |
| 0503F |
|
156 |
145 |
$205.14 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
12 |
$172.36 |
| 0502F |
|
868 |
714 |
$10.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
521 |
437 |
$3.24 |
| 99024 |
|
976 |
861 |
$0.00 |
| 3294F |
|
1,419 |
1,298 |
$0.00 |
| 3292F |
|
2,133 |
1,616 |
$0.00 |