| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
869 |
587 |
$74K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
437 |
277 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,260 |
3,013 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
740 |
733 |
$24K |
| 90670 |
|
597 |
596 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
705 |
704 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
278 |
260 |
$3K |
| 90680 |
|
305 |
305 |
$3K |
| 90698 |
|
301 |
301 |
$3K |
| 81002 |
|
1,109 |
680 |
$3K |
| 90656 |
|
86 |
86 |
$2K |
| 90657 |
|
174 |
173 |
$2K |
| 90686 |
|
98 |
98 |
$1K |
| 90654 |
|
115 |
115 |
$1K |
| 90648 |
|
99 |
99 |
$891.00 |
| 90633 |
|
78 |
78 |
$729.49 |
| 90744 |
|
78 |
78 |
$699.75 |
| 99460 |
|
12 |
12 |
$621.16 |
| 99462 |
|
17 |
12 |
$469.24 |
| 90723 |
|
48 |
48 |
$432.00 |
| 92552 |
|
265 |
265 |
$360.47 |
| 90710 |
|
25 |
25 |
$225.00 |
| 85018 |
|
492 |
492 |
$114.37 |
| 90734 |
|
12 |
12 |
$108.00 |
| 90715 |
|
12 |
12 |
$108.00 |
| 90696 |
|
12 |
12 |
$108.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
20 |
$43.85 |