| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,845 |
1,841 |
$151K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,761 |
2,600 |
$120K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
132 |
129 |
$99K |
| 59426 |
|
100 |
100 |
$84K |
| 59025 |
Fetal non-stress test |
3,704 |
1,742 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
714 |
701 |
$48K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
276 |
276 |
$25K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
274 |
274 |
$16K |
| 59430 |
|
61 |
61 |
$14K |
| 59425 |
|
15 |
15 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
544 |
477 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
54 |
54 |
$5K |
| 54150 |
|
81 |
81 |
$4K |
| 81025 |
|
567 |
555 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56 |
52 |
$2K |
| 58300 |
|
15 |
14 |
$558.90 |
| 96127 |
|
165 |
162 |
$447.74 |
| 90756 |
|
15 |
15 |
$402.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
27 |
$274.28 |
| 0502F |
|
5,759 |
3,304 |
$0.56 |
| 0500F |
|
222 |
220 |
$0.00 |