| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
25,884 |
12,283 |
$945K |
| 59410 |
|
1,321 |
906 |
$800K |
| 59515 |
|
636 |
391 |
$356K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
3,506 |
2,401 |
$214K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,166 |
1,413 |
$132K |
| 59025 |
Fetal non-stress test |
4,642 |
1,805 |
$118K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,800 |
1,243 |
$84K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,212 |
2,169 |
$70K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,373 |
913 |
$52K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
792 |
402 |
$24K |
| 59430 |
|
1,281 |
783 |
$23K |
| 87110 |
|
402 |
387 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
251 |
230 |
$7K |
| 76801 |
|
317 |
206 |
$6K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
35 |
12 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
44 |
$4K |
| H0049 |
Alcohol and/or drug screening |
330 |
270 |
$4K |
| 99385 |
|
84 |
37 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
93 |
91 |
$776.91 |