| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,906 |
1,708 |
$211K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,616 |
6,316 |
$166K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
29 |
27 |
$67K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
945 |
590 |
$67K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
477 |
307 |
$47K |
| 76801 |
|
147 |
139 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
126 |
123 |
$10K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
81 |
79 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
294 |
240 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
41 |
$3K |
| 99459 |
|
75 |
75 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
61 |
55 |
$1K |
| 76813 |
|
13 |
13 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
17 |
$619.67 |
| 81025 |
|
49 |
49 |
$339.87 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.12 |