| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,454 |
2,595 |
$205K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,666 |
1,980 |
$189K |
| 99215 |
Prolong outpt/office vis |
1,585 |
981 |
$73K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
23 |
15 |
$21K |
| 99205 |
Prolong outpt/office vis |
302 |
275 |
$20K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
23 |
12 |
$19K |
| 59025 |
Fetal non-stress test |
457 |
158 |
$15K |
| 81000 |
|
4,558 |
2,331 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
733 |
509 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
116 |
105 |
$8K |
| 58300 |
|
40 |
25 |
$4K |
| 81025 |
|
986 |
783 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
14 |
$1K |
| 90658 |
|
46 |
38 |
$829.62 |
| 87808 |
|
20 |
13 |
$297.35 |
| 96160 |
|
15 |
12 |
$219.00 |
| 87905 |
|
20 |
13 |
$200.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
55 |
47 |
$0.00 |