| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
4,028 |
2,754 |
$191K |
| J3490 |
Unclassified drugs |
1,714 |
1,646 |
$138K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,299 |
2,953 |
$134K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,709 |
1,596 |
$67K |
| 99215 |
Prolong outpt/office vis |
444 |
439 |
$50K |
| Z1034 |
|
903 |
603 |
$49K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
495 |
492 |
$32K |
| 0500F |
|
366 |
365 |
$32K |
| 3351F |
|
375 |
372 |
$27K |
| 59430 |
|
308 |
287 |
$21K |
| 76801 |
|
177 |
173 |
$12K |
| 99381 |
|
94 |
94 |
$8K |
| 81025 |
|
2,825 |
2,663 |
$7K |
| Z1032 |
|
41 |
41 |
$7K |
| 88141 |
|
277 |
246 |
$6K |
| S9083 |
Global fee urgent care centers |
112 |
111 |
$6K |
| Z6410 |
|
779 |
523 |
$6K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
78 |
53 |
$5K |
| 99000 |
|
1,790 |
1,632 |
$5K |
| Z6500 |
|
41 |
41 |
$5K |
| S0197 |
Prenatal vitamins, 30-day supply |
2,861 |
1,721 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
79 |
77 |
$3K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
750 |
530 |
$3K |
| 81002 |
|
1,472 |
1,181 |
$3K |
| 97802 |
|
89 |
89 |
$3K |
| 90715 |
|
29 |
29 |
$3K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
203 |
198 |
$2K |
| 99460 |
|
34 |
34 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
17 |
15 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
85 |
77 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
29 |
29 |
$1K |
| 82947 |
|
409 |
392 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$937.08 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12 |
12 |
$597.20 |
| 85018 |
|
198 |
170 |
$353.76 |
| 92557 |
|
32 |
32 |
$350.74 |
| 92551 |
|
12 |
12 |
$131.65 |
| 90633 |
|
12 |
12 |
$108.00 |
| 0502F |
|
405 |
327 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
13 |
13 |
$0.00 |
| 3078F |
|
27 |
25 |
$0.00 |
| 3074F |
|
15 |
15 |
$0.00 |
| 0501F |
|
37 |
37 |
$0.00 |