| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
60 |
60 |
$46K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
815 |
761 |
$32K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
29 |
29 |
$23K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
132 |
131 |
$13K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
154 |
144 |
$10K |
| 59430 |
|
44 |
44 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
131 |
125 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
44 |
42 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
90 |
86 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
25 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
27 |
25 |
$1K |
| 59025 |
Fetal non-stress test |
22 |
12 |
$546.80 |