| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,334 |
823 |
$29K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
53 |
51 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
485 |
347 |
$16K |
| 59430 |
|
161 |
138 |
$12K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
116 |
51 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
30 |
29 |
$2K |
| 81003 |
|
1,334 |
737 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
12 |
$964.86 |
| 99000 |
|
80 |
62 |
$582.18 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
65 |
35 |
$545.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
27 |
$333.11 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
14 |
$135.32 |
| 81025 |
|
18 |
16 |
$124.71 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$114.45 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
53 |
30 |
$106.05 |
| 36415 |
Collection of venous blood by venipuncture |
70 |
37 |
$0.00 |