| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
523 |
521 |
$442K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,124 |
4,811 |
$240K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,268 |
2,950 |
$209K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,426 |
1,573 |
$168K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,935 |
1,935 |
$157K |
| 59430 |
|
591 |
589 |
$121K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
159 |
158 |
$120K |
| 59025 |
Fetal non-stress test |
3,772 |
1,681 |
$101K |
| 76830 |
Ultrasound, transvaginal |
1,421 |
1,415 |
$99K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
983 |
981 |
$97K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,547 |
1,454 |
$80K |
| 76801 |
|
797 |
786 |
$55K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,959 |
1,956 |
$37K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
383 |
383 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
293 |
289 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,667 |
1,642 |
$20K |
| 54150 |
|
213 |
212 |
$18K |
| 84703 |
|
2,256 |
2,199 |
$12K |
| 59514 |
|
12 |
12 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
93 |
93 |
$8K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
152 |
151 |
$8K |
| 99459 |
|
422 |
421 |
$6K |
| 90715 |
|
133 |
132 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
1,140 |
1,095 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
280 |
270 |
$3K |
| 58300 |
|
26 |
26 |
$1K |
| 76820 |
|
44 |
34 |
$1K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
26 |
24 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
19 |
17 |
$869.48 |
| 96127 |
|
175 |
173 |
$470.22 |
| 81002 |
|
154 |
149 |
$402.36 |
| 90674 |
|
14 |
14 |
$395.23 |
| 90756 |
|
13 |
12 |
$363.39 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$54.96 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
25 |
24 |
$54.00 |
| 0502F |
|
598 |
395 |
$0.00 |