| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
3,375 |
1,510 |
$248K |
| 59425 |
|
3,219 |
2,196 |
$197K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,760 |
2,070 |
$132K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
503 |
409 |
$43K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
325 |
235 |
$18K |
| 81002 |
|
6,928 |
3,730 |
$16K |
| 59430 |
|
93 |
66 |
$12K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
137 |
105 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
102 |
89 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
30 |
13 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
78 |
51 |
$8K |
| 81025 |
|
1,402 |
1,011 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
224 |
152 |
$2K |
| 90688 |
|
174 |
125 |
$1K |
| 90756 |
|
42 |
26 |
$608.74 |