| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
11,588 |
8,651 |
$607K |
| 59410 |
|
77 |
76 |
$77K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,827 |
2,579 |
$71K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,006 |
772 |
$43K |
| 59025 |
Fetal non-stress test |
662 |
429 |
$31K |
| 59430 |
|
217 |
201 |
$27K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
191 |
189 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
94 |
93 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
88 |
61 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
44 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
42 |
37 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
78 |
67 |
$2K |
| 99383 |
|
22 |
14 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
65 |
65 |
$640.39 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$87.36 |
| 81025 |
|
53 |
52 |
$46.71 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$21.82 |
| 1159F |
|
5,506 |
4,661 |
$0.00 |
| 3078F |
|
6,237 |
4,830 |
$0.00 |
| 1160F |
|
6,042 |
5,088 |
$0.00 |
| 0502F |
|
1,104 |
864 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
139 |
130 |
$0.00 |
| 3511F |
|
27 |
24 |
$0.00 |
| 4035F |
|
36 |
34 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
78 |
65 |
$0.00 |
| 1031F |
|
2,201 |
1,698 |
$0.00 |
| 3074F |
|
6,877 |
5,586 |
$0.00 |
| 3008F |
|
5,695 |
4,791 |
$0.00 |
| 1036F |
|
2,774 |
2,245 |
$0.00 |
| 0501F |
|
1,227 |
980 |
$0.00 |
| 3079F |
|
305 |
274 |
$0.00 |
| 1126F |
|
443 |
432 |
$0.00 |
| 2001F |
|
2,112 |
1,785 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
378 |
354 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
752 |
583 |
$0.00 |