| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$14K |
| 59025 |
Fetal non-stress test |
312 |
228 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
56 |
56 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
27 |
$903.57 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
13 |
$858.39 |
| 82950 |
|
52 |
51 |
$281.27 |
| 90715 |
|
12 |
12 |
$241.44 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
66 |
63 |
$234.14 |
| 81025 |
|
26 |
26 |
$198.84 |
| 81002 |
|
25 |
24 |
$58.89 |