| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81000 |
|
1,298 |
1,123 |
$11K |
| 59425 |
|
769 |
523 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,151 |
2,802 |
$6K |
| 92551 |
|
528 |
527 |
$838.38 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
125 |
100 |
$725.76 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$498.93 |
| 99383 |
|
15 |
15 |
$271.40 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
42 |
40 |
$226.31 |
| 99000 |
|
435 |
428 |
$183.09 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$101.87 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
82 |
79 |
$90.00 |
| 3079F |
|
369 |
345 |
$61.83 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$60.00 |
| 85018 |
|
119 |
119 |
$57.40 |
| 3080F |
|
784 |
711 |
$57.00 |
| 3078F |
|
815 |
755 |
$36.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
15 |
$36.00 |
| 3074F |
|
379 |
356 |
$34.83 |
| 3077F |
|
353 |
321 |
$21.00 |
| 90670 |
|
18 |
18 |
$20.00 |
| 99173 |
|
534 |
530 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
53 |
53 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
89 |
87 |
$0.00 |
| 99401 |
|
98 |
98 |
$0.00 |
| 97803 |
|
83 |
83 |
$0.00 |
| 81025 |
|
14 |
13 |
$0.00 |
| 96151 |
|
82 |
82 |
$0.00 |
| 1220F |
|
90 |
90 |
$0.00 |
| 3075F |
|
60 |
55 |
$0.00 |
| 99381 |
|
19 |
19 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |
| H2000 |
Comprehensive multidisciplinary evaluation |
28 |
28 |
$0.00 |