| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,019 |
3,325 |
$163K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,007 |
687 |
$46K |
| 59430 |
|
94 |
89 |
$9K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
26 |
26 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
50 |
50 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
42 |
39 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$915.87 |
| 81025 |
|
69 |
68 |
$484.41 |
| 90715 |
|
13 |
13 |
$329.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$145.40 |