| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
7,515 |
5,561 |
$287K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,969 |
2,769 |
$76K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,172 |
1,074 |
$42K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
417 |
407 |
$29K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
206 |
182 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
120 |
116 |
$10K |
| 59430 |
|
188 |
168 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
140 |
125 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
70 |
63 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
24 |
$2K |
| 81025 |
|
1,294 |
1,219 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$983.29 |
| 76801 |
|
16 |
16 |
$888.96 |
| 81002 |
|
1,846 |
1,777 |
$828.23 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
12 |
12 |
$376.48 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
56 |
52 |
$209.76 |
| 36415 |
Collection of venous blood by venipuncture |
215 |
205 |
$0.00 |