| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
27 |
26 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
462 |
327 |
$14K |
| 59430 |
|
74 |
74 |
$6K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
68 |
51 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
129 |
98 |
$5K |
| 76801 |
|
40 |
39 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
42 |
36 |
$3K |
| 81002 |
|
616 |
395 |
$2K |
| 90658 |
|
25 |
25 |
$773.03 |
| 81025 |
|
127 |
120 |
$748.04 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$675.81 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$643.12 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$156.12 |
| 85018 |
|
33 |
32 |
$66.30 |