| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,091 |
3,812 |
$202K |
| 59426 |
|
231 |
229 |
$198K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
148 |
148 |
$114K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,350 |
1,348 |
$109K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,611 |
1,605 |
$94K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,110 |
1,082 |
$80K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
798 |
797 |
$72K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,394 |
1,294 |
$67K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
534 |
530 |
$42K |
| 76830 |
Ultrasound, transvaginal |
590 |
585 |
$40K |
| 59025 |
Fetal non-stress test |
1,031 |
392 |
$29K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
459 |
459 |
$29K |
| 76801 |
|
404 |
384 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
896 |
872 |
$27K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
465 |
425 |
$25K |
| 59430 |
|
85 |
85 |
$20K |
| 81025 |
|
1,730 |
1,706 |
$12K |
| 59425 |
|
14 |
14 |
$6K |
| 51729 |
|
14 |
14 |
$3K |
| 99459 |
|
218 |
212 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
69 |
69 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
324 |
252 |
$3K |
| 58300 |
|
39 |
39 |
$2K |
| 54150 |
|
38 |
38 |
$2K |
| 51797 |
|
14 |
14 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$2K |
| 81002 |
|
366 |
355 |
$951.27 |
| 51784 |
|
15 |
15 |
$312.12 |
| 51741 |
|
15 |
15 |
$60.25 |
| 82120 |
|
20 |
20 |
$44.64 |
| 96127 |
|
12 |
12 |
$35.76 |
| 3008F |
|
5,207 |
5,006 |
$0.03 |
| 3725F |
|
30 |
30 |
$0.00 |
| 0501F |
|
121 |
121 |
$0.00 |
| 88142 |
|
51 |
51 |
$0.00 |