| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
14,398 |
7,331 |
$862K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
396 |
395 |
$213K |
| 99215 |
Prolong outpt/office vis |
1,474 |
1,207 |
$160K |
| 59430 |
|
2,140 |
1,908 |
$131K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
684 |
684 |
$109K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,015 |
1,014 |
$63K |
| 3351F |
|
1,010 |
1,010 |
$55K |
| 99205 |
Prolong outpt/office vis |
619 |
619 |
$51K |
| 59514 |
|
80 |
80 |
$42K |
| 90715 |
|
454 |
454 |
$37K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
28 |
28 |
$34K |
| 0500F |
|
539 |
539 |
$33K |
| 88141 |
|
481 |
250 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
375 |
306 |
$13K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
756 |
755 |
$8K |
| 58300 |
|
34 |
34 |
$6K |
| 81025 |
|
1,547 |
1,473 |
$4K |
| 99070 |
|
122 |
108 |
$2K |
| 76801 |
|
13 |
13 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
216 |
215 |
$954.72 |
| 3074F |
|
95 |
94 |
$0.00 |
| 3078F |
|
79 |
79 |
$0.00 |