| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
7,932 |
5,551 |
$585K |
| 59410 |
|
136 |
136 |
$120K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,128 |
1,041 |
$105K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
358 |
344 |
$73K |
| 59430 |
|
692 |
518 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
884 |
814 |
$46K |
| 59515 |
|
37 |
37 |
$32K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
174 |
172 |
$13K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
366 |
343 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
84 |
76 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
201 |
197 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
134 |
123 |
$4K |
| 76801 |
|
264 |
257 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
133 |
117 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
91 |
88 |
$1K |
| 81025 |
|
858 |
814 |
$753.81 |
| 81002 |
|
773 |
712 |
$508.17 |
| 36415 |
Collection of venous blood by venipuncture |
174 |
170 |
$98.97 |