| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,200 |
11,277 |
$963K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
309 |
289 |
$515K |
| H2016 |
Comprehensive community support services, per diem |
2,974 |
155 |
$459K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
281 |
279 |
$309K |
| 76818 |
|
2,998 |
1,455 |
$284K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,239 |
8,393 |
$271K |
| 76830 |
Ultrasound, transvaginal |
2,953 |
2,739 |
$270K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,116 |
2,909 |
$266K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,867 |
2,799 |
$194K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,819 |
1,759 |
$191K |
| 87428 |
|
2,123 |
1,829 |
$133K |
| H2014 |
Skills training and development, per 15 minutes |
4,155 |
189 |
$132K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
866 |
849 |
$122K |
| 76801 |
|
1,207 |
1,091 |
$112K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,218 |
1,167 |
$95K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
684 |
669 |
$62K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
715 |
624 |
$53K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
414 |
405 |
$47K |
| 59025 |
Fetal non-stress test |
1,205 |
742 |
$45K |
| 76813 |
|
450 |
441 |
$43K |
| H0031 |
Mental health assessment, by non-physician |
268 |
260 |
$34K |
| 58300 |
|
303 |
297 |
$33K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
39 |
37 |
$33K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
377 |
337 |
$25K |
| 81025 |
|
3,322 |
3,092 |
$22K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
719 |
681 |
$20K |
| H0038 |
Self-help/peer services, per 15 minutes |
635 |
96 |
$20K |
| T1016 |
Case management, each 15 minutes |
603 |
173 |
$19K |
| 99443 |
|
201 |
116 |
$18K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,288 |
1,090 |
$17K |
| 59514 |
|
89 |
89 |
$16K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
159 |
94 |
$10K |
| 99385 |
|
107 |
104 |
$10K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
125 |
121 |
$9K |
| 81002 |
|
2,331 |
2,114 |
$6K |
| 64435 |
|
67 |
67 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
1,462 |
1,371 |
$5K |
| 11981 |
|
28 |
27 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
63 |
59 |
$2K |
| 99441 |
|
111 |
110 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
55 |
35 |
$2K |
| 86328 |
|
36 |
32 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$1K |
| 90715 |
|
41 |
40 |
$1K |
| 99442 |
|
18 |
15 |
$1K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
46 |
26 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
41 |
$970.33 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
27 |
12 |
$731.83 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
13 |
12 |
$432.88 |
| 76376 |
|
41 |
39 |
$156.87 |
| 99000 |
|
18 |
17 |
$46.15 |
| 0502F |
|
71 |
59 |
$0.00 |
| 99072 |
|
42 |
21 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
21 |
20 |
$0.00 |
| 87481 |
|
21 |
20 |
$0.00 |
| 87511 |
|
26 |
25 |
$0.00 |
| 86769 |
|
63 |
28 |
$0.00 |