| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
13,992 |
12,097 |
$775K |
| 59430 |
|
727 |
647 |
$38K |
| 59025 |
Fetal non-stress test |
1,380 |
1,141 |
$35K |
| 81003 |
|
8,821 |
7,894 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
622 |
578 |
$20K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
298 |
192 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
130 |
116 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
131 |
115 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
41 |
39 |
$3K |
| H0031 |
Mental health assessment, by non-physician |
13 |
13 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
28 |
27 |
$1K |
| 76801 |
|
29 |
26 |
$1K |
| 85018 |
|
691 |
635 |
$709.82 |
| 81025 |
|
40 |
36 |
$73.35 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
76 |
55 |
$16.23 |
| G8484 |
Influenza immunization was not administered, reason not given |
837 |
705 |
$0.00 |
| 3078F |
|
1,356 |
1,145 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
426 |
366 |
$0.00 |
| 1000F |
|
2,893 |
2,423 |
$0.00 |
| 3074F |
|
2,080 |
1,762 |
$0.00 |
| 1036F |
|
1,838 |
1,552 |
$0.00 |
| 3079F |
|
54 |
52 |
$0.00 |
| 36416 |
|
26 |
25 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
41 |
30 |
$0.00 |