| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,479 |
14,069 |
$873K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
384 |
373 |
$236K |
| 59430 |
|
1,150 |
1,107 |
$110K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
859 |
820 |
$75K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,048 |
993 |
$65K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,052 |
991 |
$60K |
| 76801 |
|
470 |
458 |
$39K |
| 81025 |
|
6,607 |
6,018 |
$36K |
| 81003 |
|
17,597 |
11,095 |
$32K |
| 76830 |
Ultrasound, transvaginal |
305 |
290 |
$22K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
310 |
302 |
$19K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
287 |
257 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,032 |
962 |
$11K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
74 |
39 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
181 |
165 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
41 |
40 |
$2K |
| 90686 |
|
96 |
95 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
60 |
56 |
$1K |
| 90715 |
|
36 |
33 |
$1K |