| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
342 |
337 |
$268K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
223 |
222 |
$167K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,420 |
2,179 |
$155K |
| 59430 |
|
636 |
635 |
$124K |
| 76830 |
Ultrasound, transvaginal |
1,553 |
1,510 |
$104K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,033 |
1,025 |
$81K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,655 |
1,582 |
$70K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,175 |
1,008 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
817 |
785 |
$49K |
| 76801 |
|
411 |
404 |
$28K |
| 59025 |
Fetal non-stress test |
997 |
619 |
$23K |
| 76818 |
|
301 |
178 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
671 |
609 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
116 |
116 |
$7K |
| 81002 |
|
1,934 |
1,874 |
$5K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
39 |
36 |
$4K |
| 81025 |
|
452 |
444 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
42 |
39 |
$2K |
| 99218 |
|
29 |
24 |
$2K |
| 58300 |
|
12 |
12 |
$452.64 |
| 90674 |
|
16 |
16 |
$360.75 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
29 |
$264.84 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
24 |
24 |
$232.92 |
| 0502F |
|
4,389 |
2,282 |
$0.00 |