| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,834 |
1,661 |
$116K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
14 |
12 |
$6K |
| 59430 |
|
72 |
67 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
27 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
14 |
$1K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$989.19 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
15 |
$827.29 |
| 76820 |
|
36 |
26 |
$379.65 |
| 96127 |
|
69 |
67 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
12 |
$0.00 |
| 0502F |
|
40 |
27 |
$0.00 |