| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,272 |
5,395 |
$357K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,840 |
1,614 |
$157K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,745 |
1,110 |
$111K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
803 |
788 |
$110K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
123 |
122 |
$82K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
835 |
713 |
$40K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
578 |
380 |
$34K |
| 59430 |
|
268 |
266 |
$29K |
| 81002 |
|
10,595 |
5,616 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
326 |
313 |
$26K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
365 |
359 |
$26K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
282 |
259 |
$19K |
| 90715 |
|
381 |
378 |
$15K |
| 81025 |
|
1,485 |
1,445 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
549 |
489 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
439 |
431 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
182 |
177 |
$3K |
| 76801 |
|
18 |
18 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
38 |
38 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$1K |
| 90686 |
|
27 |
27 |
$458.58 |
| 0500F |
|
312 |
311 |
$0.00 |
| 0503F |
|
213 |
212 |
$0.00 |
| 0502F |
|
55 |
54 |
$0.00 |
| 99072 |
|
17 |
17 |
$0.00 |