| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
15,293 |
9,937 |
$959K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,849 |
9,092 |
$804K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,593 |
12,500 |
$798K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,158 |
4,734 |
$619K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,791 |
3,703 |
$511K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13,710 |
13,164 |
$265K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,800 |
1,786 |
$201K |
| 81002 |
|
7,726 |
5,422 |
$95K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
585 |
531 |
$92K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
727 |
720 |
$90K |
| 90461 |
|
5,849 |
5,626 |
$87K |
| 59430 |
|
408 |
393 |
$54K |
| 59410 |
|
51 |
51 |
$43K |
| 99385 |
|
521 |
462 |
$39K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
99 |
91 |
$7K |
| 99188 |
|
534 |
526 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
152 |
118 |
$5K |
| 81025 |
|
1,139 |
1,017 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
25 |
25 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$2K |
| 81003 |
|
33 |
32 |
$1K |
| 99381 |
|
12 |
12 |
$1K |
| 92552 |
|
115 |
112 |
$947.91 |
| 90698 |
|
2,800 |
2,732 |
$934.74 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
98 |
82 |
$860.09 |
| 99080 |
|
4,627 |
4,275 |
$800.34 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
620 |
393 |
$718.67 |
| 90633 |
|
845 |
815 |
$608.30 |
| 90670 |
|
3,282 |
3,206 |
$583.53 |
| 90707 |
|
147 |
144 |
$502.65 |
| 90686 |
|
1,055 |
1,026 |
$500.99 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
283 |
277 |
$339.24 |
| 99173 |
|
1,913 |
1,860 |
$186.06 |
| 85018 |
|
328 |
317 |
$139.46 |
| 90688 |
|
435 |
422 |
$127.52 |
| 90744 |
|
403 |
380 |
$82.02 |
| 90685 |
|
107 |
102 |
$80.50 |
| 90680 |
|
1,559 |
1,516 |
$44.77 |
| 83655 |
|
39 |
39 |
$41.64 |
| 90651 |
|
96 |
94 |
$24.01 |
| 90687 |
|
12 |
12 |
$23.00 |
| 96161 |
|
26 |
25 |
$11.70 |
| 90716 |
|
118 |
115 |
$11.50 |
| 94760 |
|
158 |
151 |
$3.57 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
296 |
255 |
$1.84 |
| 36416 |
|
883 |
739 |
$0.84 |
| 99090 |
|
354 |
265 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
88 |
79 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
50 |
48 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
14 |
14 |
$0.00 |
| 99177 |
|
501 |
455 |
$0.00 |
| 90648 |
|
27 |
26 |
$0.00 |
| 90734 |
|
30 |
29 |
$0.00 |