| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,347 |
8,971 |
$432K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
639 |
541 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
473 |
441 |
$24K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
208 |
194 |
$15K |
| 59025 |
Fetal non-stress test |
575 |
539 |
$15K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
14 |
14 |
$13K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
126 |
126 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
154 |
152 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
37 |
37 |
$4K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
110 |
105 |
$4K |
| 51700 |
|
191 |
101 |
$4K |
| 99459 |
|
289 |
278 |
$3K |
| 99215 |
Prolong outpt/office vis |
45 |
38 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
59 |
59 |
$2K |
| 76830 |
Ultrasound, transvaginal |
25 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
84 |
82 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
44 |
43 |
$1K |
| 81025 |
|
219 |
213 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
18 |
18 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
13 |
$848.06 |
| 90686 |
|
27 |
27 |
$513.81 |
| J1644 |
Injection, heparin sodium, per 1000 units |
192 |
101 |
$333.90 |
| 81003 |
|
49 |
49 |
$153.80 |
| 87210 |
|
29 |
24 |
$120.99 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
21 |
12 |
$104.99 |