| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
4,183 |
3,091 |
$185K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,883 |
1,532 |
$128K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
25 |
25 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
257 |
190 |
$19K |
| 59430 |
|
60 |
52 |
$10K |
| 59025 |
Fetal non-stress test |
302 |
143 |
$6K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
71 |
58 |
$5K |
| 0500F |
|
53 |
43 |
$2K |
| 0503F |
|
40 |
28 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
156 |
109 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
82 |
64 |
$792.65 |
| 90686 |
|
39 |
24 |
$511.18 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
15 |
$504.00 |
| H1000 |
Prenatal care, at-risk assessment |
30 |
27 |
$408.80 |
| 96160 |
|
31 |
26 |
$380.52 |
| 90715 |
|
14 |
13 |
$344.95 |
| 81025 |
|
87 |
67 |
$164.98 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
24 |
$0.00 |