| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
911 |
828 |
$1.12M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,441 |
3,947 |
$388K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,680 |
1,616 |
$313K |
| 76830 |
Ultrasound, transvaginal |
4,246 |
3,805 |
$307K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,232 |
2,836 |
$197K |
| 99205 |
Prolong outpt/office vis |
795 |
756 |
$134K |
| 99215 |
Prolong outpt/office vis |
1,128 |
1,030 |
$130K |
| 76813 |
|
1,199 |
1,147 |
$119K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,098 |
1,043 |
$118K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,914 |
2,692 |
$110K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,890 |
2,669 |
$108K |
| 87660 |
|
3,309 |
3,066 |
$75K |
| 87510 |
|
3,320 |
3,079 |
$73K |
| 87480 |
|
3,278 |
3,039 |
$72K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
908 |
862 |
$71K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,183 |
1,058 |
$71K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
773 |
705 |
$63K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
82 |
66 |
$51K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
631 |
533 |
$47K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
340 |
315 |
$45K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
623 |
465 |
$42K |
| 90715 |
|
972 |
929 |
$39K |
| 59510 |
|
20 |
16 |
$32K |
| 36415 |
Collection of venous blood by venipuncture |
10,500 |
9,329 |
$30K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,634 |
1,554 |
$30K |
| 59025 |
Fetal non-stress test |
758 |
468 |
$26K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
291 |
243 |
$24K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
28 |
26 |
$24K |
| 81002 |
|
7,488 |
6,171 |
$23K |
| 81025 |
|
2,948 |
2,760 |
$23K |
| 58300 |
|
385 |
352 |
$18K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
490 |
424 |
$16K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
222 |
201 |
$16K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
965 |
779 |
$13K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
14 |
13 |
$12K |
| 90674 |
|
518 |
505 |
$10K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
13 |
12 |
$10K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
836 |
782 |
$8K |
| 99000 |
|
2,764 |
2,550 |
$8K |
| 58301 |
|
82 |
73 |
$8K |
| A4550 |
Surgical trays |
172 |
154 |
$7K |
| 99385 |
|
85 |
72 |
$7K |
| 85018 |
|
1,414 |
1,285 |
$4K |
| 93976 |
|
14 |
13 |
$2K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
77 |
71 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
52 |
50 |
$2K |
| 11981 |
|
12 |
12 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$819.90 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
14 |
14 |
$720.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
46 |
44 |
$472.95 |
| 36410 |
|
13 |
12 |
$93.49 |