| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
976 |
851 |
$38K |
| 59426 |
|
38 |
38 |
$29K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
12 |
$9K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
91 |
90 |
$9K |
| 59430 |
|
12 |
12 |
$2K |
| 76801 |
|
27 |
27 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$1K |
| 59025 |
Fetal non-stress test |
40 |
27 |
$673.60 |