| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
1,124 |
1,117 |
$959K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
810 |
803 |
$616K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,527 |
10,840 |
$527K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,892 |
6,597 |
$451K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
3,177 |
3,169 |
$251K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,146 |
2,143 |
$196K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,824 |
1,819 |
$160K |
| 59430 |
|
660 |
658 |
$146K |
| 59410 |
|
107 |
107 |
$103K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,663 |
1,663 |
$103K |
| 59514 |
|
110 |
109 |
$93K |
| 76830 |
Ultrasound, transvaginal |
1,346 |
1,296 |
$90K |
| 99386 |
|
646 |
644 |
$74K |
| 99385 |
|
682 |
675 |
$66K |
| 76801 |
|
855 |
823 |
$56K |
| 59425 |
|
80 |
79 |
$41K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,641 |
1,637 |
$30K |
| 54150 |
|
462 |
461 |
$26K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
490 |
464 |
$14K |
| 58300 |
|
242 |
241 |
$13K |
| 81025 |
|
1,919 |
1,884 |
$12K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
13 |
13 |
$12K |
| 90715 |
|
235 |
234 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
817 |
808 |
$7K |
| 99215 |
Prolong outpt/office vis |
83 |
80 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
120 |
114 |
$6K |
| 58558 |
|
52 |
51 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
648 |
523 |
$5K |
| 76857 |
|
188 |
178 |
$5K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
41 |
40 |
$3K |
| 90651 |
|
25 |
25 |
$3K |
| 99442 |
|
71 |
67 |
$2K |
| 58301 |
|
26 |
26 |
$2K |
| 59025 |
Fetal non-stress test |
78 |
63 |
$1K |
| 58100 |
|
25 |
25 |
$1K |
| 57454 |
|
13 |
13 |
$1K |
| 90658 |
|
64 |
64 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
372 |
366 |
$617.78 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
51 |
51 |
$448.39 |
| 99443 |
|
16 |
13 |
$381.62 |
| 81002 |
|
173 |
168 |
$194.13 |
| 82962 |
|
46 |
44 |
$110.08 |
| 99441 |
|
13 |
13 |
$88.31 |
| 85018 |
|
37 |
37 |
$85.60 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
124 |
123 |
$85.50 |
| 3075F |
|
703 |
694 |
$0.00 |
| 0503F |
|
116 |
116 |
$0.00 |
| 1034F |
|
493 |
459 |
$0.00 |
| 3079F |
|
945 |
936 |
$0.00 |
| 1036F |
|
6,029 |
5,610 |
$0.00 |
| 99024 |
|
689 |
642 |
$0.00 |
| 3008F |
|
5,978 |
5,659 |
$0.00 |
| 3074F |
|
5,882 |
5,564 |
$0.00 |
| 99000 |
|
20 |
20 |
$0.00 |
| 1035F |
|
54 |
47 |
$0.00 |
| 3080F |
|
43 |
41 |
$0.00 |
| 3725F |
|
63 |
63 |
$0.00 |
| 3077F |
|
207 |
205 |
$0.00 |
| 3078F |
|
5,823 |
5,496 |
$0.00 |
| 1159F |
|
6,466 |
6,011 |
$0.00 |
| 1160F |
|
6,470 |
6,014 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |