| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
426 |
340 |
$19K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
54 |
53 |
$9K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
89 |
78 |
$6K |
| 76830 |
Ultrasound, transvaginal |
66 |
63 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
47 |
47 |
$3K |
| 76801 |
|
35 |
34 |
$2K |
| 93975 |
|
12 |
12 |
$2K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
172 |
120 |
$2K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
121 |
87 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$970.14 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
65 |
64 |
$819.85 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$722.02 |
| 81002 |
|
224 |
161 |
$481.16 |
| 81025 |
|
17 |
17 |
$114.79 |