| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,893 |
5,156 |
$262K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
120 |
115 |
$176K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,355 |
2,194 |
$159K |
| 76830 |
Ultrasound, transvaginal |
1,250 |
1,199 |
$124K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,079 |
1,043 |
$97K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,087 |
1,067 |
$87K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
866 |
735 |
$79K |
| 76801 |
|
488 |
472 |
$49K |
| 76813 |
|
467 |
456 |
$45K |
| 99219 |
|
507 |
478 |
$40K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,488 |
1,366 |
$40K |
| 59025 |
Fetal non-stress test |
1,127 |
814 |
$40K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
311 |
304 |
$38K |
| 59425 |
|
92 |
86 |
$31K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
175 |
173 |
$26K |
| 59426 |
|
128 |
123 |
$24K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
283 |
277 |
$24K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
407 |
369 |
$22K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
307 |
219 |
$21K |
| 76821 |
|
226 |
155 |
$17K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
77 |
77 |
$11K |
| 81025 |
|
1,562 |
1,483 |
$10K |
| 99000 |
|
3,136 |
2,991 |
$10K |
| 76820 |
|
278 |
189 |
$10K |
| 99385 |
|
97 |
92 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
118 |
112 |
$7K |
| 81002 |
|
2,146 |
1,650 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
101 |
96 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
104 |
99 |
$2K |
| 99386 |
|
13 |
13 |
$1K |
| 90674 |
|
57 |
55 |
$1K |
| 90715 |
|
14 |
13 |
$332.82 |
| 36416 |
|
13 |
12 |
$23.61 |
| 0503F |
|
12 |
12 |
$0.00 |
| A4550 |
Surgical trays |
118 |
100 |
$0.00 |