| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,811 |
3,899 |
$355K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,747 |
2,365 |
$251K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
184 |
182 |
$199K |
| 99215 |
Prolong outpt/office vis |
735 |
700 |
$93K |
| 59025 |
Fetal non-stress test |
2,667 |
1,246 |
$80K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
584 |
569 |
$64K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
574 |
553 |
$53K |
| 76830 |
Ultrasound, transvaginal |
415 |
406 |
$37K |
| 59430 |
|
353 |
349 |
$36K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
188 |
182 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
812 |
763 |
$14K |
| 59514 |
|
14 |
13 |
$12K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
447 |
435 |
$10K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
94 |
85 |
$7K |
| 76813 |
|
29 |
27 |
$3K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
54 |
54 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
16 |
13 |
$1K |
| 99070 |
|
97 |
93 |
$612.75 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
116 |
110 |
$435.52 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
40 |
40 |
$200.00 |
| 81025 |
|
13 |
13 |
$99.20 |