| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
4,487 |
3,642 |
$220K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,826 |
1,488 |
$139K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
34 |
28 |
$33K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
217 |
179 |
$18K |
| 59430 |
|
82 |
73 |
$14K |
| 59025 |
Fetal non-stress test |
462 |
256 |
$11K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
68 |
61 |
$5K |
| 0503F |
|
96 |
81 |
$5K |
| 0500F |
|
56 |
56 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
231 |
181 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
157 |
152 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
127 |
108 |
$2K |
| 96160 |
|
118 |
103 |
$2K |
| 90686 |
|
81 |
68 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
54 |
53 |
$1K |
| 54150 |
|
15 |
15 |
$930.00 |
| 90715 |
|
34 |
29 |
$918.18 |
| 81025 |
|
139 |
131 |
$330.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
143 |
116 |
$16.18 |