| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
7,143 |
4,386 |
$391K |
| 59410 |
|
259 |
250 |
$260K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,217 |
1,104 |
$140K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,777 |
3,218 |
$115K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
566 |
490 |
$73K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,253 |
1,139 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,270 |
1,095 |
$39K |
| 59430 |
|
534 |
451 |
$35K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
337 |
315 |
$27K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
850 |
771 |
$24K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
451 |
423 |
$21K |
| 99401 |
|
596 |
512 |
$19K |
| 99385 |
|
305 |
283 |
$17K |
| 81025 |
|
3,704 |
3,372 |
$15K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
178 |
170 |
$12K |
| 81003 |
|
8,531 |
6,072 |
$12K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
726 |
632 |
$10K |
| 76818 |
|
45 |
39 |
$4K |
| H0049 |
Alcohol and/or drug screening |
224 |
206 |
$3K |
| 76801 |
|
103 |
88 |
$3K |
| 80306 |
|
493 |
410 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
292 |
284 |
$3K |
| 76830 |
Ultrasound, transvaginal |
46 |
44 |
$2K |
| 80305 |
|
94 |
93 |
$767.55 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$637.55 |
| 1170F |
|
1,890 |
1,478 |
$437.25 |
| 1126F |
|
1,160 |
894 |
$31.17 |
| 3078F |
|
595 |
455 |
$0.01 |
| 2000F |
|
906 |
666 |
$0.00 |
| 3075F |
|
30 |
28 |
$0.00 |
| 3008F |
|
895 |
699 |
$0.00 |
| 1036F |
|
119 |
104 |
$0.00 |
| 2001F |
|
593 |
410 |
$0.00 |
| 2010F |
|
932 |
713 |
$0.00 |
| 3079F |
|
187 |
161 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
129 |
112 |
$0.00 |
| 3074F |
|
713 |
563 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
18 |
16 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
248 |
186 |
$0.00 |
| 1101F |
|
12 |
12 |
$0.00 |
| 1125F |
|
50 |
45 |
$0.00 |
| 0001F |
|
14 |
12 |
$0.00 |
| 1160F |
|
1,734 |
1,366 |
$0.00 |
| 3028F |
|
999 |
771 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
818 |
606 |
$0.00 |
| 1159F |
|
1,831 |
1,446 |
$0.00 |
| 3288F |
|
70 |
65 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
149 |
127 |
$0.00 |
| 3725F |
|
18 |
16 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
178 |
109 |
$0.00 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
13 |
12 |
$0.00 |
| 1175F |
|
14 |
14 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
31 |
28 |
$0.00 |