| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
94 |
94 |
$195K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,101 |
1,975 |
$133K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,491 |
2,132 |
$99K |
| 59426 |
|
60 |
60 |
$52K |
| 76830 |
Ultrasound, transvaginal |
531 |
502 |
$35K |
| 76813 |
|
485 |
471 |
$33K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
319 |
311 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
396 |
381 |
$24K |
| 90715 |
|
724 |
720 |
$23K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
719 |
696 |
$15K |
| 76801 |
|
162 |
148 |
$11K |
| 59425 |
|
17 |
17 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
90 |
89 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
723 |
719 |
$8K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
143 |
56 |
$8K |
| 81025 |
|
629 |
607 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
25 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
15 |
15 |
$2K |
| 81003 |
|
626 |
607 |
$1K |
| 76820 |
|
27 |
12 |
$702.00 |
| 0500F |
|
24 |
24 |
$0.00 |