| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,424 |
4,140 |
$153K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,769 |
2,358 |
$139K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
45 |
41 |
$67K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,165 |
1,043 |
$63K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,820 |
1,028 |
$47K |
| 59025 |
Fetal non-stress test |
1,484 |
890 |
$33K |
| 81025 |
|
14,487 |
11,059 |
$31K |
| G9357 |
Post-partum screenings, evaluations and education performed |
314 |
270 |
$29K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
657 |
538 |
$27K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
376 |
345 |
$24K |
| H1000 |
Prenatal care, at-risk assessment |
281 |
208 |
$22K |
| 76830 |
Ultrasound, transvaginal |
326 |
309 |
$18K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
434 |
367 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,539 |
1,334 |
$14K |
| 93975 |
|
27 |
27 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
237 |
178 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
41 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
316 |
261 |
$3K |
| 80305 |
|
681 |
449 |
$3K |
| 59426 |
|
241 |
232 |
$2K |
| 90686 |
|
96 |
92 |
$2K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
65 |
64 |
$1K |
| 99215 |
Prolong outpt/office vis |
33 |
30 |
$861.28 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
96 |
92 |
$385.00 |
| 99459 |
|
18 |
16 |
$160.94 |
| 3078F |
|
1,558 |
1,187 |
$0.00 |
| 85014 |
|
542 |
492 |
$0.00 |
| 01960 |
|
72 |
70 |
$0.00 |
| 3074F |
|
2,438 |
1,881 |
$0.00 |
| 85018 |
|
542 |
488 |
$0.00 |
| 3079F |
|
896 |
719 |
$0.00 |
| 3075F |
|
13 |
12 |
$0.00 |
| 81000 |
|
2,964 |
1,544 |
$0.00 |
| 0503F |
|
16 |
15 |
$0.00 |