| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
666 |
622 |
$1.20M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,218 |
13,595 |
$1.01M |
| 76830 |
Ultrasound, transvaginal |
2,188 |
2,127 |
$274K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,169 |
1,939 |
$197K |
| 59510 |
|
124 |
80 |
$168K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,191 |
1,160 |
$163K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,278 |
1,244 |
$140K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,053 |
943 |
$86K |
| 99385 |
|
685 |
674 |
$85K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
826 |
798 |
$59K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
447 |
438 |
$44K |
| 81025 |
|
8,592 |
8,059 |
$42K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
231 |
226 |
$35K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,074 |
1,031 |
$21K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
108 |
102 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
77 |
74 |
$8K |
| 99459 |
|
213 |
192 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
78 |
77 |
$3K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
13 |
13 |
$2K |
| H0049 |
Alcohol and/or drug screening |
287 |
276 |
$2K |
| 0503F |
|
207 |
151 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
13 |
$990.99 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
13 |
12 |
$431.88 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
21 |
17 |
$283.55 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
13 |
12 |
$236.88 |
| 0500F |
|
1,032 |
1,000 |
$0.00 |