| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
4,101 |
3,211 |
$171K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,143 |
4,448 |
$157K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,141 |
2,705 |
$139K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
200 |
180 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
87 |
87 |
$7K |
| 81003 |
|
1,818 |
1,452 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
433 |
382 |
$3K |
| 90670 |
|
97 |
96 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
47 |
38 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
13 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
49 |
48 |
$1K |
| 82962 |
|
237 |
205 |
$852.38 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
302 |
299 |
$843.57 |
| 90686 |
|
91 |
77 |
$808.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
127 |
119 |
$751.86 |
| 0011A |
|
77 |
46 |
$449.76 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
120 |
87 |
$139.80 |
| 85018 |
|
29 |
26 |
$26.45 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
533 |
387 |
$25.28 |
| 90698 |
|
27 |
27 |
$20.50 |
| G8484 |
Influenza immunization was not administered, reason not given |
1,052 |
909 |
$0.00 |
| 3078F |
|
945 |
811 |
$0.00 |
| 90461 |
|
27 |
27 |
$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) |
75 |
69 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
16 |
12 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |
| 1000F |
|
2,159 |
1,885 |
$0.00 |
| 3074F |
|
1,319 |
1,149 |
$0.00 |
| 1036F |
|
1,270 |
1,113 |
$0.00 |
| 3079F |
|
45 |
41 |
$0.00 |
| 36416 |
|
35 |
27 |
$0.00 |