| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,271 |
1,599 |
$58K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
188 |
98 |
$6K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
87 |
54 |
$6K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
82 |
57 |
$5K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
18 |
13 |
$4K |
| 59430 |
|
36 |
25 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
19 |
16 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
87 |
70 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
35 |
17 |
$1K |
| 82948 |
|
421 |
306 |
$1K |
| 81025 |
|
126 |
115 |
$815.56 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$789.72 |
| 90674 |
|
19 |
19 |
$371.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
19 |
$109.76 |
| 82962 |
|
151 |
99 |
$0.00 |