| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
99 |
94 |
$123K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,822 |
1,480 |
$72K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,067 |
469 |
$49K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
606 |
505 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
702 |
621 |
$42K |
| 59025 |
Fetal non-stress test |
1,085 |
414 |
$33K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
299 |
258 |
$30K |
| 76830 |
Ultrasound, transvaginal |
411 |
380 |
$24K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
320 |
235 |
$16K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
108 |
105 |
$15K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,013 |
876 |
$15K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
254 |
232 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
819 |
734 |
$12K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
140 |
126 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
349 |
285 |
$9K |
| 59426 |
|
12 |
12 |
$6K |
| 81025 |
|
1,311 |
1,094 |
$6K |
| 76801 |
|
69 |
62 |
$4K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
625 |
534 |
$2K |
| 99385 |
|
14 |
13 |
$1K |
| 82962 |
|
316 |
301 |
$809.83 |
| 90674 |
|
25 |
25 |
$618.35 |
| 81003 |
|
315 |
274 |
$428.74 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
36 |
$312.76 |
| 90756 |
|
14 |
12 |
$260.89 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
12 |
$168.07 |
| 87210 |
|
65 |
65 |
$153.10 |
| J2675 |
Injection, progesterone, per 50 mg |
75 |
13 |
$46.15 |
| 0502F |
|
33 |
31 |
$0.00 |