| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
9,029 |
4,455 |
$534K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,835 |
2,291 |
$153K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,042 |
1,633 |
$133K |
| 76830 |
Ultrasound, transvaginal |
849 |
806 |
$112K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,312 |
1,081 |
$105K |
| 59515 |
|
68 |
68 |
$79K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,226 |
2,040 |
$56K |
| 59430 |
|
592 |
494 |
$31K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
836 |
808 |
$12K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
117 |
112 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
54 |
50 |
$4K |
| 99195 |
|
116 |
107 |
$3K |
| 76801 |
|
28 |
26 |
$3K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
12 |
12 |
$2K |
| 76641 |
|
65 |
65 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
27 |
$856.86 |
| 76818 |
|
63 |
38 |
$179.05 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$89.35 |
| 1159F |
|
24 |
12 |
$0.00 |
| 3078F |
|
19 |
13 |
$0.00 |
| 96103 |
|
16 |
15 |
$0.00 |
| 58740 |
|
12 |
12 |
$0.00 |