| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,268 |
2,656 |
$169K |
| 59025 |
Fetal non-stress test |
1,460 |
1,048 |
$33K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
357 |
300 |
$29K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
593 |
545 |
$26K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
161 |
138 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
224 |
196 |
$18K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
157 |
156 |
$18K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$17K |
| 76830 |
Ultrasound, transvaginal |
242 |
170 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
255 |
178 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
49 |
42 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
45 |
45 |
$3K |
| 81002 |
|
774 |
731 |
$2K |
| 85018 |
|
671 |
665 |
$2K |