| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
37,815 |
27,099 |
$4.63M |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
7,380 |
4,548 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,400 |
11,821 |
$9K |
| 59425 |
|
2,319 |
1,509 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,504 |
2,463 |
$885.67 |
| 99215 |
Prolong outpt/office vis |
329 |
250 |
$394.78 |
| 59025 |
Fetal non-stress test |
4,637 |
1,093 |
$326.52 |
| 81005 |
|
15,410 |
9,531 |
$289.67 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
561 |
535 |
$285.94 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
24 |
24 |
$271.66 |
| 59430 |
|
208 |
189 |
$241.92 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,626 |
2,758 |
$225.26 |
| 81003 |
|
10,959 |
6,076 |
$209.17 |
| 81025 |
|
6,542 |
4,786 |
$209.13 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
838 |
650 |
$198.27 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
411 |
210 |
$188.85 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
260 |
250 |
$92.51 |
| 96156 |
|
339 |
299 |
$75.70 |
| 99000 |
|
5,047 |
3,796 |
$68.93 |
| 3074F |
|
459 |
268 |
$62.44 |
| J3490 |
Unclassified drugs |
267 |
206 |
$44.64 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
279 |
255 |
$34.30 |
| 97803 |
|
51 |
51 |
$25.23 |
| 99401 |
|
32 |
32 |
$21.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$18.76 |
| 81000 |
|
579 |
418 |
$14.62 |
| 87490 |
|
197 |
162 |
$7.12 |
| 87590 |
|
197 |
162 |
$7.12 |
| 2001F |
|
814 |
484 |
$0.00 |
| Z1034 |
|
9,627 |
6,532 |
$0.00 |
| 1036F |
|
676 |
399 |
$0.00 |
| 3008F |
|
815 |
484 |
$0.00 |
| 1111F |
|
670 |
389 |
$0.00 |
| Z6410 |
|
504 |
483 |
$0.00 |
| Z6406 |
|
94 |
92 |
$0.00 |
| Z1038 |
|
354 |
336 |
$0.00 |
| Z6204 |
|
202 |
201 |
$0.00 |
| Z1032 |
|
54 |
54 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
12 |
12 |
$0.00 |
| 85018 |
|
58 |
47 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
387 |
238 |
$0.00 |
| 3079F |
|
123 |
80 |
$0.00 |
| Z6400 |
|
1,022 |
966 |
$0.00 |
| 3078F |
|
310 |
174 |
$0.00 |
| Z6500 |
|
253 |
252 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
404 |
248 |
$0.00 |
| Z6304 |
|
452 |
399 |
$0.00 |
| 90715 |
|
90 |
62 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
15 |
12 |
$0.00 |
| 99201 |
|
54 |
54 |
$0.00 |
| 59426 |
|
24 |
15 |
$0.00 |