| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
1,656 |
963 |
$188K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,396 |
1,172 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
471 |
402 |
$30K |
| 59430 |
|
40 |
38 |
$7K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
28 |
26 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
166 |
148 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
373 |
286 |
$842.82 |
| 81002 |
|
1,646 |
1,343 |
$580.64 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
31 |
27 |
$76.99 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
127 |
95 |
$75.37 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
44 |
29 |
$0.00 |