| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
1,014 |
1,009 |
$564K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,439 |
10,529 |
$454K |
| 59025 |
Fetal non-stress test |
3,821 |
1,698 |
$136K |
| 76830 |
Ultrasound, transvaginal |
1,323 |
1,160 |
$121K |
| 59514 |
|
152 |
150 |
$99K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,086 |
1,079 |
$92K |
| 99000 |
|
5,535 |
4,645 |
$57K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,137 |
5,718 |
$33K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
436 |
435 |
$31K |
| 99243 |
|
335 |
335 |
$28K |
| 99222 |
Initial hospital care, per day, moderate complexity |
360 |
333 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
492 |
489 |
$24K |
| 81025 |
|
3,026 |
2,876 |
$19K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
256 |
252 |
$17K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
190 |
177 |
$16K |
| 81003 |
|
9,271 |
5,392 |
$14K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
107 |
106 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
525 |
497 |
$11K |
| 99223 |
Prolong inpt eval add15 m |
102 |
96 |
$9K |
| 90715 |
|
158 |
158 |
$6K |
| 99218 |
|
83 |
79 |
$4K |
| 59430 |
|
42 |
42 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
322 |
293 |
$3K |
| 82950 |
|
766 |
751 |
$2K |
| 87210 |
|
624 |
609 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
30 |
26 |
$2K |
| 82951 |
|
176 |
171 |
$2K |
| 90686 |
|
82 |
81 |
$1K |
| 99234 |
|
14 |
14 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
27 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
42 |
27 |
$525.29 |
| 82947 |
|
155 |
127 |
$388.16 |
| 0502F |
|
1,196 |
790 |
$0.00 |