| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
501 |
450 |
$34K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
13 |
12 |
$19K |
| 59025 |
Fetal non-stress test |
131 |
82 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
403 |
187 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
30 |
24 |
$2K |
| 76830 |
Ultrasound, transvaginal |
14 |
13 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 81025 |
|
161 |
148 |
$799.40 |
| 81002 |
|
875 |
604 |
$223.28 |