| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
4,605 |
3,237 |
$270K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,468 |
2,044 |
$230K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
608 |
531 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
377 |
371 |
$50K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
526 |
501 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
175 |
157 |
$15K |
| 59410 |
|
14 |
14 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
70 |
70 |
$10K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
75 |
62 |
$9K |
| 90698 |
|
23 |
23 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
907 |
850 |
$6K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
55 |
52 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
86 |
83 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
108 |
92 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
21 |
$3K |
| 76813 |
|
33 |
28 |
$2K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13 |
12 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
12 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
162 |
137 |
$1K |
| 90707 |
|
26 |
26 |
$1K |
| 90670 |
|
32 |
30 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
77 |
67 |
$915.57 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
12 |
12 |
$626.61 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
92 |
86 |
$588.49 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
12 |
$332.54 |
| 90461 |
|
165 |
161 |
$192.04 |
| 90686 |
|
260 |
259 |
$156.30 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
182 |
176 |
$101.84 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
26 |
$100.77 |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$67.54 |
| H0049 |
Alcohol and/or drug screening |
31 |
31 |
$53.79 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
78 |
67 |
$25.74 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
15 |
15 |
$19.48 |
| 85018 |
|
147 |
146 |
$2.32 |
| 97802 |
|
123 |
119 |
$0.00 |
| 36416 |
|
121 |
119 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
13 |
12 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 92567 |
|
40 |
37 |
$0.00 |
| 99408 |
|
42 |
42 |
$0.00 |
| 99177 |
|
252 |
251 |
$0.00 |
| 99173 |
|
121 |
117 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
123 |
119 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
92 |
77 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
59 |
$0.00 |
| 81002 |
|
167 |
164 |
$0.00 |
| 92552 |
|
116 |
114 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
31 |
31 |
$0.00 |
| 90633 |
|
45 |
45 |
$0.00 |
| 59025 |
Fetal non-stress test |
17 |
16 |
$0.00 |
| 99188 |
|
30 |
30 |
$0.00 |