| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
20,740 |
11,371 |
$649K |
| 0502F |
|
14,801 |
6,663 |
$406K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
191 |
168 |
$172K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,001 |
1,347 |
$84K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,729 |
1,260 |
$71K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,608 |
3,223 |
$69K |
| 76801 |
|
1,339 |
918 |
$49K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
53 |
46 |
$47K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
968 |
929 |
$45K |
| 0500F |
|
1,718 |
1,194 |
$43K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,057 |
609 |
$42K |
| 76830 |
Ultrasound, transvaginal |
1,166 |
1,047 |
$39K |
| 0503F |
|
1,027 |
702 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
913 |
852 |
$32K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
951 |
682 |
$31K |
| 59025 |
Fetal non-stress test |
1,147 |
409 |
$21K |
| 76818 |
|
353 |
145 |
$13K |
| 58300 |
|
195 |
179 |
$11K |
| 99385 |
|
139 |
136 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
691 |
655 |
$8K |
| 76857 |
|
186 |
169 |
$8K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
307 |
151 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
423 |
408 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
964 |
729 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
92 |
90 |
$5K |
| 81025 |
|
2,408 |
1,980 |
$3K |
| 11982 |
|
47 |
44 |
$2K |
| 87210 |
|
409 |
360 |
$1K |
| 96127 |
|
128 |
80 |
$1K |
| 99386 |
|
13 |
13 |
$1K |
| 58301 |
|
61 |
60 |
$1K |
| 81002 |
|
449 |
373 |
$660.10 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$474.57 |
| 58100 |
|
28 |
28 |
$434.50 |
| 82105 |
|
152 |
57 |
$0.00 |