| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
2,724 |
1,581 |
$118K |
| 96160 |
|
924 |
694 |
$11K |
| 99000 |
|
802 |
583 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
69 |
58 |
$5K |
| 90686 |
|
169 |
102 |
$3K |
| 0500F |
|
45 |
37 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
31 |
27 |
$1K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
16 |
12 |
$659.36 |
| 0503F |
|
13 |
12 |
$651.95 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$558.72 |
| 59025 |
Fetal non-stress test |
41 |
31 |
$472.90 |
| 81025 |
|
73 |
59 |
$333.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |