| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
764 |
710 |
$1.15M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,682 |
7,400 |
$593K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,691 |
11,202 |
$364K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,382 |
2,312 |
$183K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,664 |
1,614 |
$164K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,413 |
1,358 |
$147K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,868 |
1,743 |
$142K |
| 76801 |
|
1,325 |
1,221 |
$118K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
139 |
137 |
$113K |
| 76830 |
Ultrasound, transvaginal |
1,224 |
1,186 |
$104K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,176 |
1,163 |
$100K |
| 99215 |
Prolong outpt/office vis |
509 |
462 |
$46K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,787 |
1,719 |
$44K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
491 |
483 |
$37K |
| 58558 |
|
43 |
38 |
$36K |
| 59025 |
Fetal non-stress test |
1,221 |
722 |
$35K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
283 |
281 |
$26K |
| 58300 |
|
354 |
340 |
$23K |
| 99223 |
Prolong inpt eval add15 m |
146 |
138 |
$21K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
275 |
260 |
$21K |
| 81025 |
|
2,934 |
2,720 |
$18K |
| 59410 |
|
16 |
16 |
$14K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
235 |
228 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
219 |
203 |
$12K |
| 99205 |
Prolong outpt/office vis |
79 |
79 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
633 |
584 |
$9K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
25 |
25 |
$9K |
| 99233 |
Prolong inpt eval add15 m |
94 |
39 |
$7K |
| 58301 |
|
80 |
74 |
$6K |
| 99222 |
Initial hospital care, per day, moderate complexity |
54 |
54 |
$6K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
63 |
41 |
$5K |
| 59426 |
|
13 |
13 |
$4K |
| 99385 |
|
43 |
43 |
$4K |
| 99219 |
|
29 |
26 |
$3K |
| 57454 |
|
14 |
14 |
$2K |
| 99386 |
|
13 |
13 |
$2K |
| 11981 |
|
12 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
42 |
41 |
$1K |
| 81002 |
|
236 |
212 |
$449.71 |
| 88142 |
|
15 |
15 |
$51.77 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$33.75 |
| 99000 |
|
46 |
43 |
$20.14 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
210 |
203 |
$7.57 |
| 0503F |
|
95 |
86 |
$0.00 |
| 87081 |
|
13 |
12 |
$0.00 |