| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
3,920 |
3,046 |
$220K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
248 |
230 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166 |
161 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
197 |
179 |
$15K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
567 |
563 |
$15K |
| 59430 |
|
49 |
45 |
$14K |
| 76830 |
Ultrasound, transvaginal |
131 |
125 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
491 |
487 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
82 |
82 |
$10K |
| 76818 |
|
88 |
58 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
232 |
231 |
$6K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
46 |
42 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
66 |
47 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
70 |
70 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
42 |
40 |
$3K |
| 76813 |
|
27 |
27 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
36 |
30 |
$3K |
| 76801 |
|
15 |
14 |
$1K |
| 76820 |
|
41 |
25 |
$900.95 |
| 81025 |
|
93 |
85 |
$773.10 |
| 59025 |
Fetal non-stress test |
13 |
13 |
$369.38 |
| 81003 |
|
49 |
45 |
$161.70 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
14 |
14 |
$155.52 |
| H0049 |
Alcohol and/or drug screening |
14 |
14 |
$110.87 |
| 81002 |
|
16 |
15 |
$51.15 |
| 96127 |
|
589 |
463 |
$9.00 |