| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
5,042 |
3,753 |
$387K |
| 96158 |
|
3,625 |
2,277 |
$273K |
| 96156 |
|
3,666 |
3,281 |
$259K |
| 59425 |
|
2,862 |
2,059 |
$197K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,067 |
2,900 |
$104K |
| 59430 |
|
1,110 |
1,082 |
$87K |
| 97802 |
|
1,672 |
1,583 |
$82K |
| H1000 |
Prenatal care, at-risk assessment |
545 |
517 |
$81K |
| 96159 |
|
1,873 |
1,116 |
$61K |
| 99215 |
Prolong outpt/office vis |
349 |
344 |
$47K |
| 97803 |
|
1,306 |
1,212 |
$43K |
| 96152 |
|
1,050 |
740 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
655 |
647 |
$34K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,432 |
1,113 |
$26K |
| 96150 |
|
899 |
836 |
$25K |
| 90715 |
|
541 |
533 |
$19K |
| 81003 |
|
9,212 |
6,986 |
$17K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
816 |
618 |
$11K |
| 99401 |
|
644 |
637 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
140 |
139 |
$10K |
| 90686 |
|
405 |
400 |
$8K |
| 96151 |
|
402 |
371 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
219 |
216 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,127 |
1,092 |
$5K |
| 81025 |
|
1,285 |
1,189 |
$3K |
| S9452 |
Nutrition classes, non-physician provider, per session |
217 |
217 |
$3K |
| 96167 |
|
34 |
32 |
$3K |
| H2000 |
Comprehensive multidisciplinary evaluation |
196 |
196 |
$3K |
| 96154 |
|
67 |
57 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
87 |
81 |
$2K |
| J3490 |
Unclassified drugs |
185 |
128 |
$2K |
| 85018 |
|
374 |
359 |
$744.61 |
| 99070 |
|
292 |
206 |
$667.27 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
16 |
13 |
$164.36 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
43 |
42 |
$16.00 |
| 81002 |
|
23 |
23 |
$5.16 |
| 96160 |
|
32 |
32 |
$0.00 |