| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,958 |
1,915 |
$46K |
| 90698 |
|
834 |
817 |
$22K |
| 90697 |
|
677 |
677 |
$22K |
| 90633 |
|
1,776 |
1,758 |
$9K |
| 90715 |
|
390 |
385 |
$6K |
| 90710 |
|
283 |
275 |
$6K |
| 90670 |
|
1,042 |
1,029 |
$5K |
| 90696 |
|
193 |
187 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
250 |
239 |
$3K |
| 90651 |
|
501 |
498 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
100 |
99 |
$2K |
| 90734 |
|
453 |
447 |
$2K |
| 90671 |
|
426 |
424 |
$2K |
| 90680 |
|
337 |
334 |
$2K |
| 81025 |
|
284 |
277 |
$2K |
| 90619 |
|
290 |
290 |
$2K |
| 90677 |
|
254 |
254 |
$1K |
| 99201 |
|
62 |
57 |
$1K |
| 90707 |
|
95 |
95 |
$1K |
| H1000 |
Prenatal care, at-risk assessment |
159 |
159 |
$1K |
| 90686 |
|
210 |
210 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
81 |
80 |
$943.35 |
| 90716 |
|
177 |
172 |
$927.66 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
22 |
22 |
$925.10 |
| 90744 |
|
171 |
165 |
$865.57 |
| 90672 |
|
151 |
151 |
$783.20 |
| 90723 |
|
12 |
12 |
$311.76 |
| 90620 |
|
49 |
49 |
$261.03 |
| G9012 |
Other specified case management service not elsewhere classified |
13 |
13 |
$260.00 |
| 90685 |
|
32 |
32 |
$168.01 |
| 90681 |
|
24 |
24 |
$128.40 |
| 90648 |
|
13 |
13 |
$67.60 |
| 85018 |
|
12 |
12 |
$28.08 |
| 86580 |
|
19 |
13 |
$0.00 |