| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
94 |
62 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
55 |
38 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173 |
118 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
90 |
61 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
53 |
41 |
$2K |
| 76801 |
|
28 |
25 |
$1K |
| 81002 |
|
358 |
218 |
$751.59 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
173 |
140 |
$264.00 |
| 81025 |
|
44 |
39 |
$98.60 |
| 85018 |
|
29 |
26 |
$75.00 |