| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,069 |
1,169 |
$155K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,373 |
1,235 |
$91K |
| 76820 |
|
1,420 |
888 |
$85K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
43 |
41 |
$54K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
465 |
446 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
646 |
598 |
$21K |
| 76801 |
|
165 |
151 |
$16K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
199 |
170 |
$14K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
172 |
152 |
$12K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
15 |
12 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
157 |
153 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
563 |
529 |
$7K |
| 90715 |
|
134 |
132 |
$5K |
| 90686 |
|
216 |
210 |
$3K |
| 76830 |
Ultrasound, transvaginal |
42 |
41 |
$3K |
| 81025 |
|
425 |
404 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
112 |
111 |
$3K |
| 99385 |
|
51 |
46 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$386.88 |
| 81002 |
|
13 |
13 |
$27.09 |