| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,808 |
1,013 |
$183K |
| 0502F |
|
2,603 |
1,682 |
$150K |
| 59025 |
Fetal non-stress test |
525 |
253 |
$17K |
| 59430 |
|
92 |
64 |
$15K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
133 |
93 |
$10K |
| 0503F |
|
74 |
49 |
$8K |
| 81003 |
|
3,183 |
1,804 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
50 |
40 |
$4K |
| 76830 |
Ultrasound, transvaginal |
32 |
26 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
12 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$885.12 |
| 96127 |
|
46 |
27 |
$681.09 |
| 81002 |
|
161 |
106 |
$409.07 |
| 90686 |
|
12 |
12 |
$218.58 |