| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
5,446 |
3,141 |
$472K |
| 59430 |
|
784 |
729 |
$135K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
419 |
400 |
$73K |
| 59410 |
|
41 |
41 |
$44K |
| 59025 |
Fetal non-stress test |
2,650 |
1,241 |
$36K |
| 99223 |
Prolong inpt eval add15 m |
140 |
124 |
$18K |
| 99233 |
Prolong inpt eval add15 m |
412 |
203 |
$17K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
108 |
102 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
205 |
188 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
93 |
92 |
$8K |
| 88142 |
|
709 |
654 |
$5K |
| 76818 |
|
30 |
27 |
$3K |
| 81002 |
|
1,644 |
1,313 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52 |
51 |
$2K |
| 81025 |
|
783 |
741 |
$2K |
| 99236 |
Prolong inpt eval add15 m |
13 |
12 |
$2K |
| 99385 |
|
15 |
13 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
13 |
$891.17 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$675.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
13 |
$122.14 |