| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
3,298 |
2,295 |
$192K |
| 59515 |
|
30 |
30 |
$35K |
| 59410 |
|
30 |
29 |
$29K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
197 |
172 |
$28K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
136 |
110 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
73 |
$9K |
| 59025 |
Fetal non-stress test |
246 |
153 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
50 |
50 |
$5K |
| 81025 |
|
336 |
301 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
97 |
90 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
49 |
48 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
106 |
98 |
$3K |
| 59430 |
|
90 |
85 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
28 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
14 |
$777.30 |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$252.56 |
| 87210 |
|
27 |
27 |
$59.03 |
| 81002 |
|
46 |
41 |
$20.88 |