| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
10,853 |
9,192 |
$640K |
| 59410 |
|
117 |
104 |
$120K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,556 |
1,455 |
$98K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
372 |
345 |
$59K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
530 |
485 |
$46K |
| 59025 |
Fetal non-stress test |
2,327 |
2,102 |
$34K |
| 76801 |
|
241 |
212 |
$28K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
242 |
214 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
225 |
210 |
$10K |
| 59430 |
|
43 |
38 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
62 |
54 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
105 |
87 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
49 |
40 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
60 |
54 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$1K |
| H0049 |
Alcohol and/or drug screening |
74 |
62 |
$830.69 |
| 96127 |
|
601 |
494 |
$711.86 |
| 81025 |
|
83 |
60 |
$242.48 |
| 36415 |
Collection of venous blood by venipuncture |
46 |
44 |
$149.38 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18 |
12 |
$132.03 |
| 0501F |
|
49 |
39 |
$0.00 |
| 99459 |
|
15 |
12 |
$0.00 |