| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
1,486 |
839 |
$103K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
162 |
140 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
150 |
112 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
117 |
93 |
$5K |
| 59430 |
|
134 |
89 |
$4K |
| 90715 |
|
39 |
25 |
$327.20 |
| 90682 |
|
42 |
30 |
$326.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
183 |
131 |
$220.00 |
| 3074F |
|
439 |
368 |
$150.00 |
| 3078F |
|
373 |
292 |
$104.98 |
| 3008F |
|
622 |
474 |
$25.22 |
| 90686 |
|
22 |
14 |
$22.35 |
| 36415 |
Collection of venous blood by venipuncture |
347 |
291 |
$21.19 |
| 90656 |
|
12 |
12 |
$16.33 |
| 4000F |
|
300 |
226 |
$0.00 |
| 1220F |
|
676 |
510 |
$0.00 |
| 2000F |
|
592 |
443 |
$0.00 |
| 2001F |
|
885 |
640 |
$0.00 |
| 1126F |
|
195 |
151 |
$0.00 |
| 1000F |
|
700 |
511 |
$0.00 |
| 1036F |
|
20 |
12 |
$0.00 |
| 1160F |
|
681 |
520 |
$0.00 |
| 1159F |
|
683 |
521 |
$0.00 |