| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
2,336 |
908 |
$144K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,463 |
2,129 |
$66K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
493 |
264 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
439 |
282 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
217 |
116 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
508 |
273 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
166 |
90 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,779 |
1,189 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
36 |
$1K |
| 99188 |
|
146 |
115 |
$311.74 |
| 99442 |
|
38 |
25 |
$266.17 |
| 99441 |
|
72 |
55 |
$248.83 |
| 36415 |
Collection of venous blood by venipuncture |
245 |
140 |
$125.00 |
| 96127 |
|
716 |
403 |
$104.20 |
| 90651 |
|
77 |
58 |
$88.76 |
| 90461 |
|
838 |
472 |
$79.15 |
| 3074F |
|
2,444 |
1,403 |
$50.00 |
| 90686 |
|
681 |
523 |
$35.94 |
| 90474 |
|
39 |
29 |
$30.00 |
| 92551 |
|
858 |
440 |
$14.59 |
| 1159F |
|
3,667 |
1,752 |
$0.00 |
| 90633 |
|
199 |
148 |
$0.00 |
| 90670 |
|
236 |
164 |
$0.00 |
| 3078F |
|
2,562 |
1,371 |
$0.00 |
| 3725F |
|
1,060 |
576 |
$0.00 |
| 1158F |
|
151 |
115 |
$0.00 |
| 90648 |
|
173 |
115 |
$0.00 |
| 99177 |
|
657 |
356 |
$0.00 |
| 1160F |
|
3,602 |
1,730 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 90710 |
|
26 |
26 |
$0.00 |
| 1126F |
|
1,179 |
449 |
$0.00 |
| 3008F |
|
3,540 |
2,011 |
$0.00 |
| 96161 |
|
265 |
134 |
$0.00 |
| 90723 |
|
165 |
117 |
$0.00 |
| 1036F |
|
1,044 |
562 |
$0.00 |
| 1170F |
|
417 |
272 |
$0.00 |
| 3079F |
|
16 |
13 |
$0.00 |
| 3044F |
|
13 |
13 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
14 |
$0.00 |