| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
348 |
347 |
$280K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
203 |
201 |
$155K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,062 |
1,903 |
$101K |
| 59430 |
|
283 |
283 |
$56K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
888 |
807 |
$41K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
470 |
470 |
$39K |
| 59025 |
Fetal non-stress test |
1,387 |
654 |
$30K |
| 90715 |
|
274 |
274 |
$9K |
| 59514 |
|
15 |
12 |
$8K |
| 59425 |
|
13 |
13 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
2,329 |
2,245 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
759 |
745 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
86 |
86 |
$5K |
| 81025 |
|
539 |
525 |
$4K |
| 90688 |
|
105 |
105 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
16 |
$1K |
| 90686 |
|
60 |
59 |
$1K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
39 |
39 |
$958.59 |
| 81002 |
|
191 |
191 |
$498.74 |
| 0502F |
|
160 |
81 |
$0.00 |