| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
4,744 |
2,464 |
$258K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,636 |
3,275 |
$148K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,618 |
1,618 |
$119K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,115 |
698 |
$81K |
| 81000 |
|
2,564 |
1,978 |
$16K |
| 87210 |
|
4,725 |
4,217 |
$15K |
| 81025 |
|
3,953 |
3,623 |
$9K |
| 81003 |
|
3,542 |
2,630 |
$7K |
| 99215 |
Prolong outpt/office vis |
65 |
64 |
$7K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
38 |
38 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63 |
61 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
41 |
40 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
13 |
12 |
$518.07 |
| A4402 |
Lubricant, per ounce |
1,407 |
1,269 |
$34.01 |