| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
1,728 |
1,716 |
$1.19M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27,552 |
23,545 |
$1.08M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12,075 |
12,001 |
$685K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
12,697 |
7,558 |
$564K |
| J7296 |
Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg |
512 |
511 |
$434K |
| 58300 |
|
5,185 |
2,630 |
$387K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
682 |
680 |
$263K |
| 58558 |
|
2,436 |
1,232 |
$174K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,908 |
1,530 |
$142K |
| 76830 |
Ultrasound, transvaginal |
2,894 |
2,869 |
$137K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,495 |
2,475 |
$123K |
| 99233 |
Prolong inpt eval add15 m |
3,335 |
1,726 |
$118K |
| 99000 |
|
21,866 |
20,572 |
$114K |
| Z1034 |
|
1,855 |
1,220 |
$105K |
| 57454 |
|
2,492 |
1,238 |
$103K |
| 81002 |
|
21,917 |
14,692 |
$101K |
| 81025 |
|
9,795 |
9,519 |
$100K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,730 |
1,045 |
$94K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,100 |
1,093 |
$78K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,174 |
773 |
$52K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
825 |
719 |
$52K |
| 58301 |
|
2,109 |
1,058 |
$50K |
| 76813 |
|
576 |
562 |
$48K |
| 76801 |
|
671 |
655 |
$40K |
| 88150 |
|
2,449 |
2,445 |
$38K |
| 59514 |
|
107 |
106 |
$37K |
| 58110 |
|
1,183 |
1,166 |
$36K |
| 58100 |
|
1,393 |
699 |
$30K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
42 |
42 |
$29K |
| 59425 |
|
979 |
580 |
$28K |
| 90715 |
|
1,010 |
976 |
$27K |
| 57505 |
|
1,098 |
546 |
$27K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
444 |
409 |
$24K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
310 |
310 |
$22K |
| 59025 |
Fetal non-stress test |
917 |
469 |
$18K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
921 |
808 |
$17K |
| 90651 |
|
71 |
71 |
$15K |
| 36415 |
Collection of venous blood by venipuncture |
6,744 |
6,147 |
$15K |
| H1000 |
Prenatal care, at-risk assessment |
140 |
139 |
$13K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
376 |
374 |
$12K |
| 87210 |
|
2,697 |
2,637 |
$12K |
| 59430 |
|
271 |
264 |
$10K |
| H2000 |
Comprehensive multidisciplinary evaluation |
130 |
130 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
675 |
656 |
$8K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
2,675 |
2,616 |
$7K |
| 99201 |
|
511 |
317 |
$7K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
730 |
637 |
$7K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
12 |
12 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
258 |
249 |
$7K |
| 11981 |
|
80 |
40 |
$6K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,854 |
1,846 |
$6K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
596 |
570 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
910 |
886 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
94 |
90 |
$3K |
| 99205 |
Prolong outpt/office vis |
26 |
26 |
$2K |
| Z6500 |
|
16 |
16 |
$2K |
| Z1032 |
|
17 |
17 |
$2K |
| 99441 |
|
194 |
190 |
$2K |
| 96156 |
|
282 |
281 |
$2K |
| 11982 |
|
26 |
12 |
$1K |
| 97803 |
|
195 |
187 |
$1K |
| 99401 |
|
85 |
83 |
$507.49 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
157 |
157 |
$272.88 |
| 57160 |
|
12 |
12 |
$189.08 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
79 |
79 |
$135.01 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
13 |
13 |
$129.10 |
| Z6400 |
|
16 |
16 |
$121.12 |
| S9452 |
Nutrition classes, non-physician provider, per session |
17 |
17 |
$100.36 |
| 99024 |
|
57 |
54 |
$0.00 |