| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
4,007 |
2,233 |
$192K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,328 |
440 |
$149K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
965 |
499 |
$80K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
808 |
578 |
$56K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
15 |
12 |
$11K |
| 99000 |
|
608 |
477 |
$11K |
| 0500F |
|
116 |
94 |
$8K |
| 59430 |
|
24 |
12 |
$3K |
| 0503F |
|
47 |
38 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
24 |
$2K |
| 90686 |
|
71 |
57 |
$1K |
| 96160 |
|
79 |
53 |
$976.30 |
| 81025 |
|
72 |
52 |
$381.69 |
| 90656 |
|
12 |
12 |
$243.75 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
14 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
87 |
56 |
$0.00 |