| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
9,452 |
4,884 |
$688K |
| 59425 |
|
4,293 |
3,386 |
$274K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,134 |
3,571 |
$221K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
798 |
716 |
$59K |
| 81003 |
|
19,264 |
12,737 |
$35K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
355 |
287 |
$24K |
| 59430 |
|
383 |
302 |
$23K |
| 76830 |
Ultrasound, transvaginal |
160 |
143 |
$9K |
| 99354 |
|
121 |
114 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
148 |
137 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
73 |
73 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
64 |
51 |
$5K |
| 76801 |
|
69 |
53 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
119 |
104 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
31 |
28 |
$1K |
| 87210 |
|
62 |
54 |
$274.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
58 |
36 |
$150.28 |
| 59025 |
Fetal non-stress test |
16 |
12 |
$34.07 |
| 3074F |
|
1,065 |
919 |
$0.00 |
| 90686 |
|
32 |
19 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
12 |
$0.00 |
| 3078F |
|
772 |
662 |
$0.00 |
| 81025 |
|
12 |
12 |
$0.00 |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
31 |
29 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$0.00 |