| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
9,531 |
5,360 |
$335K |
| 59430 |
|
1,096 |
765 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,240 |
854 |
$31K |
| 76801 |
|
406 |
321 |
$10K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
246 |
200 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
678 |
329 |
$4K |
| 81002 |
|
6,036 |
3,340 |
$2K |
| 81025 |
|
1,243 |
845 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
86 |
83 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
46 |
32 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
965 |
805 |
$1K |
| 90715 |
|
104 |
87 |
$991.17 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
69 |
39 |
$926.04 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
105 |
91 |
$584.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
185 |
89 |
$356.56 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
53 |
20 |
$268.68 |
| 3074F |
|
7,854 |
4,834 |
$221.20 |
| 81003 |
|
49 |
36 |
$60.77 |
| 3078F |
|
7,054 |
4,087 |
$2.10 |
| 1000F |
|
5,794 |
3,650 |
$0.00 |
| 2000F |
|
9,533 |
5,313 |
$0.00 |
| 1220F |
|
3,582 |
2,436 |
$0.00 |
| 4000F |
|
3,270 |
2,134 |
$0.00 |
| 2010F |
|
405 |
261 |
$0.00 |
| 3075F |
|
418 |
264 |
$0.00 |
| 3044F |
|
1,373 |
910 |
$0.00 |
| 3079F |
|
1,697 |
986 |
$0.00 |
| 3008F |
|
3,032 |
1,821 |
$0.00 |
| 99000 |
|
325 |
187 |
$0.00 |
| 2001F |
|
9,534 |
5,305 |
$0.00 |
| 1126F |
|
3,842 |
2,578 |
$0.00 |
| 1125F |
|
99 |
84 |
$0.00 |
| 1157F |
|
356 |
147 |
$0.00 |
| 1160F |
|
2,363 |
1,409 |
$0.00 |
| 1159F |
|
2,362 |
1,409 |
$0.00 |
| 0502F |
|
22 |
17 |
$0.00 |