| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
290 |
252 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
174 |
167 |
$12K |
| 76830 |
Ultrasound, transvaginal |
119 |
117 |
$11K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
89 |
87 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
80 |
70 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
49 |
45 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
29 |
29 |
$3K |
| 59025 |
Fetal non-stress test |
76 |
59 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
93 |
80 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38 |
36 |
$981.23 |
| 81025 |
|
123 |
120 |
$603.36 |
| 81002 |
|
40 |
28 |
$39.43 |
| 36416 |
|
14 |
14 |
$36.00 |
| 99000 |
|
144 |
136 |
$10.26 |
| 0500F |
|
35 |
35 |
$0.00 |
| A4550 |
Surgical trays |
13 |
12 |
$0.00 |