| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
4,362 |
3,349 |
$318K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
939 |
676 |
$66K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
372 |
365 |
$35K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
41 |
40 |
$24K |
| 59514 |
|
40 |
40 |
$22K |
| 99205 |
Prolong outpt/office vis |
30 |
30 |
$5K |
| 59025 |
Fetal non-stress test |
168 |
55 |
$5K |
| 59430 |
|
52 |
49 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109 |
104 |
$3K |
| 81002 |
|
749 |
622 |
$2K |
| 90715 |
|
24 |
24 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
57 |
56 |
$348.27 |
| 90686 |
|
15 |
15 |
$334.08 |