| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
489 |
418 |
$703K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
5,529 |
5,001 |
$433K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
8,807 |
6,987 |
$411K |
| G9357 |
Post-partum screenings, evaluations and education performed |
3,205 |
2,447 |
$270K |
| H1000 |
Prenatal care, at-risk assessment |
2,035 |
1,689 |
$198K |
| 76801 |
|
3,025 |
2,613 |
$145K |
| 54150 |
|
834 |
783 |
$128K |
| 59510 |
|
110 |
89 |
$114K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
700 |
628 |
$27K |
| 90715 |
|
800 |
756 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,048 |
898 |
$24K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
355 |
283 |
$21K |
| 59514 |
|
121 |
101 |
$17K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
281 |
162 |
$15K |
| 82950 |
|
2,687 |
2,619 |
$15K |
| 59426 |
|
26 |
25 |
$12K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
189 |
179 |
$11K |
| 59025 |
Fetal non-stress test |
320 |
180 |
$9K |
| G0008 |
Administration of influenza virus vaccine |
370 |
336 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
884 |
859 |
$7K |
| 59425 |
|
21 |
19 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
979 |
925 |
$4K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
82 |
77 |
$4K |
| 90674 |
|
113 |
111 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
301 |
275 |
$3K |
| 99401 |
|
237 |
214 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
51 |
48 |
$2K |
| 99205 |
Prolong outpt/office vis |
32 |
27 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
54 |
53 |
$1K |
| 90756 |
|
28 |
27 |
$755.94 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
35 |
35 |
$701.77 |
| 99242 |
|
13 |
13 |
$657.28 |
| 99217 |
|
20 |
14 |
$612.93 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
38 |
32 |
$489.60 |
| 81025 |
|
140 |
122 |
$363.00 |
| 90658 |
|
13 |
12 |
$118.80 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
77 |
69 |
$108.80 |
| 0500F |
|
488 |
481 |
$0.00 |
| 0503F |
|
129 |
129 |
$0.00 |