| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
3,709 |
2,541 |
$319K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,299 |
3,019 |
$117K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,283 |
1,213 |
$58K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
311 |
261 |
$27K |
| 99381 |
|
177 |
158 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
233 |
187 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
101 |
100 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
79 |
79 |
$6K |
| 99385 |
|
12 |
12 |
$941.74 |
| 59430 |
|
45 |
26 |
$903.67 |
| 82948 |
|
806 |
747 |
$754.66 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
12 |
$727.76 |
| 81002 |
|
3,221 |
2,246 |
$629.73 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
270 |
238 |
$555.12 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
67 |
53 |
$510.86 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
69 |
67 |
$440.00 |
| 81025 |
|
1,017 |
794 |
$411.45 |
| 90723 |
|
19 |
19 |
$400.00 |
| 90681 |
|
52 |
50 |
$340.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
195 |
154 |
$310.00 |
| 99442 |
|
27 |
25 |
$300.05 |
| 90698 |
|
42 |
41 |
$220.00 |
| 90474 |
|
50 |
49 |
$140.00 |
| 90744 |
|
27 |
26 |
$110.00 |
| 90670 |
|
67 |
65 |
$110.00 |
| 3074F |
|
1,623 |
1,561 |
$75.00 |
| 90715 |
|
24 |
14 |
$72.00 |
| 3008F |
|
3,145 |
2,822 |
$56.65 |
| 90686 |
|
60 |
39 |
$35.00 |
| 3351F |
|
2,846 |
2,597 |
$0.00 |
| 3079F |
|
466 |
425 |
$0.00 |
| 3075F |
|
129 |
126 |
$0.00 |
| 3044F |
|
250 |
243 |
$0.00 |
| 4010F |
|
175 |
151 |
$0.00 |
| 0500F |
|
12 |
12 |
$0.00 |
| 0501F |
|
27 |
15 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
83 |
80 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16 |
12 |
$0.00 |
| 3078F |
|
1,805 |
1,611 |
$0.00 |
| 3725F |
|
3,220 |
2,931 |
$0.00 |
| 3077F |
|
89 |
73 |
$0.00 |
| 1160F |
|
498 |
461 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
269 |
229 |
$0.00 |
| 1159F |
|
519 |
480 |
$0.00 |
| 0502F |
|
46 |
26 |
$0.00 |
| 90648 |
|
18 |
18 |
$0.00 |