| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
129 |
119 |
$1K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
15 |
15 |
$543.32 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
19 |
19 |
$119.45 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
88 |
76 |
$92.51 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
308 |
303 |
$67.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,286 |
1,247 |
$48.00 |
| 90674 |
|
13 |
13 |
$28.51 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
23 |
23 |
$25.23 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
506 |
495 |
$18.10 |
| 90686 |
|
88 |
88 |
$9.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
1,447 |
1,398 |
$0.00 |
| 3078F |
|
1,157 |
1,114 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$0.00 |
| 3077F |
|
320 |
313 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
311 |
305 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
50 |
50 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
168 |
168 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |
| 3046F |
|
12 |
12 |
$0.00 |
| 3050F |
|
88 |
84 |
$0.00 |
| 90461 |
|
47 |
47 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
14 |
14 |
$0.00 |
| 99173 |
|
32 |
32 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$0.00 |
| 2001F |
|
1,969 |
1,899 |
$0.00 |
| 3008F |
|
1,969 |
1,899 |
$0.00 |
| 3074F |
|
1,178 |
1,135 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
1,644 |
1,585 |
$0.00 |
| 3048F |
|
283 |
275 |
$0.00 |
| 1036F |
|
1,286 |
1,247 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
134 |
132 |
$0.00 |
| 3049F |
|
161 |
160 |
$0.00 |
| 3079F |
|
433 |
422 |
$0.00 |
| 3080F |
|
106 |
105 |
$0.00 |
| 3075F |
|
192 |
187 |
$0.00 |
| 85018 |
|
51 |
51 |
$0.00 |
| 92551 |
|
33 |
33 |
$0.00 |