| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
54 |
54 |
$40K |
| 59426 |
|
39 |
39 |
$30K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
300 |
244 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
428 |
408 |
$17K |
| 59430 |
|
67 |
67 |
$10K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
116 |
115 |
$9K |
| 59425 |
|
14 |
14 |
$6K |
| 76830 |
Ultrasound, transvaginal |
58 |
58 |
$4K |
| 76801 |
|
52 |
52 |
$4K |
| 59025 |
Fetal non-stress test |
169 |
107 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
34 |
34 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
42 |
42 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
31 |
27 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
34 |
13 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
316 |
294 |
$830.40 |
| 54150 |
|
12 |
12 |
$618.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21 |
21 |
$147.00 |
| 0502F |
|
517 |
316 |
$0.00 |
| 0500F |
|
12 |
12 |
$0.00 |