| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
922 |
915 |
$747K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,703 |
10,837 |
$528K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,954 |
5,612 |
$390K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
505 |
502 |
$386K |
| 58558 |
|
480 |
470 |
$303K |
| 76830 |
Ultrasound, transvaginal |
4,149 |
4,060 |
$285K |
| 59430 |
|
1,080 |
1,065 |
$222K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,672 |
2,663 |
$217K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,647 |
1,643 |
$148K |
| 99215 |
Prolong outpt/office vis |
1,529 |
1,416 |
$143K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,963 |
1,828 |
$124K |
| 59025 |
Fetal non-stress test |
3,173 |
1,503 |
$122K |
| 76801 |
|
1,735 |
1,699 |
$118K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,893 |
1,870 |
$109K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,101 |
1,099 |
$103K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
4,565 |
4,527 |
$87K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,185 |
1,173 |
$73K |
| 99385 |
|
666 |
663 |
$65K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
78 |
77 |
$54K |
| 81025 |
|
6,016 |
5,792 |
$40K |
| 59514 |
|
38 |
38 |
$34K |
| 58300 |
|
597 |
591 |
$32K |
| 99386 |
|
259 |
259 |
$31K |
| 81003 |
|
16,815 |
11,803 |
$30K |
| 76818 |
|
437 |
219 |
$30K |
| 59425 |
|
39 |
39 |
$20K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
394 |
372 |
$19K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
208 |
208 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
532 |
506 |
$13K |
| 58301 |
|
205 |
203 |
$12K |
| 90715 |
|
289 |
288 |
$10K |
| 54150 |
|
125 |
125 |
$7K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
208 |
208 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
300 |
298 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
426 |
351 |
$4K |
| 76998 |
|
60 |
57 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
394 |
392 |
$3K |
| 76857 |
|
114 |
109 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
49 |
39 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
29 |
29 |
$2K |
| 58100 |
|
31 |
31 |
$2K |
| 54160 |
|
18 |
18 |
$1K |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
13 |
$9.60 |
| 0502F |
|
100 |
71 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
24 |
24 |
$0.00 |