| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46,344 |
28,657 |
$1.51M |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
1,658 |
1,639 |
$955K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
3,764 |
3,704 |
$486K |
| 59514 |
|
669 |
662 |
$444K |
| 76830 |
Ultrasound, transvaginal |
3,814 |
3,700 |
$346K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,419 |
3,367 |
$287K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
4,072 |
3,651 |
$264K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,217 |
3,136 |
$250K |
| 59410 |
|
372 |
369 |
$249K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
3,641 |
3,462 |
$221K |
| 59430 |
|
2,596 |
2,554 |
$212K |
| 59515 |
|
179 |
175 |
$130K |
| 76801 |
|
1,308 |
1,258 |
$117K |
| 81002 |
|
42,780 |
25,067 |
$106K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,082 |
1,060 |
$84K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,173 |
1,153 |
$65K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
876 |
873 |
$63K |
| 81025 |
|
8,830 |
8,223 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,144 |
1,111 |
$50K |
| 59025 |
Fetal non-stress test |
1,345 |
964 |
$49K |
| 99000 |
|
4,825 |
4,568 |
$47K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
581 |
534 |
$41K |
| 90674 |
|
765 |
752 |
$20K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,624 |
1,271 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,560 |
1,522 |
$17K |
| 90715 |
|
286 |
285 |
$14K |
| 76857 |
|
277 |
272 |
$10K |
| 82950 |
|
3,164 |
3,142 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
501 |
286 |
$6K |
| 90686 |
|
337 |
329 |
$6K |
| 82951 |
|
793 |
752 |
$6K |
| 90756 |
|
115 |
113 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
27 |
25 |
$3K |
| 58300 |
|
24 |
24 |
$3K |
| 82952 |
|
793 |
752 |
$2K |
| 90661 |
|
58 |
58 |
$1K |
| 99219 |
|
16 |
15 |
$1K |
| 90656 |
|
48 |
47 |
$820.43 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$158.84 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,003 |
994 |
$0.00 |
| 0503F |
|
610 |
604 |
$0.00 |
| 0500F |
|
1,137 |
1,116 |
$0.00 |