| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
4,715 |
2,402 |
$427K |
| 59425 |
|
3,997 |
3,175 |
$333K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,461 |
4,828 |
$284K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
720 |
665 |
$54K |
| 99205 |
Prolong outpt/office vis |
288 |
275 |
$40K |
| 59410 |
|
43 |
39 |
$32K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
249 |
239 |
$14K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
112 |
94 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
124 |
114 |
$7K |
| 81001 |
|
1,249 |
1,156 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
65 |
54 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
330 |
297 |
$2K |
| 81000 |
|
908 |
756 |
$2K |
| 90686 |
|
118 |
107 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
20 |
15 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
26 |
12 |
$921.20 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
184 |
125 |
$820.48 |
| 87660 |
|
37 |
27 |
$446.71 |
| 87510 |
|
37 |
27 |
$446.71 |
| 87480 |
|
37 |
27 |
$446.71 |
| 99459 |
|
34 |
32 |
$399.04 |
| 82950 |
|
86 |
78 |
$345.05 |
| 81025 |
|
26 |
24 |
$139.48 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
15 |
$125.77 |
| 0502F |
|
2,209 |
1,525 |
$0.00 |
| 0500F |
|
129 |
126 |
$0.00 |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
13 |
12 |
$0.00 |