| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
6,393 |
5,774 |
$4.07M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,625 |
8,594 |
$466K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,974 |
2,631 |
$277K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
4,765 |
4,369 |
$277K |
| 59025 |
Fetal non-stress test |
12,133 |
9,520 |
$228K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,373 |
1,256 |
$80K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,341 |
1,061 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
382 |
335 |
$20K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
98 |
64 |
$7K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
160 |
140 |
$7K |
| 54150 |
|
27 |
26 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
507 |
348 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
56 |
29 |
$3K |
| 90686 |
|
212 |
154 |
$2K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15 |
13 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
48 |
39 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
36 |
31 |
$607.60 |
| 81025 |
|
78 |
64 |
$495.89 |
| 90715 |
|
79 |
54 |
$128.07 |
| 0500F |
|
125 |
119 |
$0.00 |
| 0503F |
|
24 |
24 |
$0.00 |
| 0502F |
|
2,124 |
1,711 |
$0.00 |