| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
4,708 |
2,303 |
$233K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,875 |
1,228 |
$130K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$11K |
| 59025 |
Fetal non-stress test |
343 |
164 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
88 |
80 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
80 |
63 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
65 |
63 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
212 |
157 |
$2K |
| 90686 |
|
104 |
77 |
$2K |
| 0500F |
|
38 |
38 |
$2K |
| 90715 |
|
12 |
12 |
$367.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
24 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
46 |
43 |
$0.00 |