| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
3,203 |
1,912 |
$163K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
158 |
153 |
$27K |
| 99385 |
|
231 |
223 |
$27K |
| 59410 |
|
27 |
26 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
709 |
628 |
$20K |
| 59430 |
|
300 |
272 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
359 |
346 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
103 |
103 |
$8K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
340 |
326 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
18 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
280 |
272 |
$2K |
| 81003 |
|
2,926 |
1,983 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
33 |
$2K |
| 76818 |
|
18 |
16 |
$2K |
| 81025 |
|
586 |
549 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17 |
15 |
$1K |
| 76801 |
|
41 |
41 |
$455.73 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
306 |
292 |
$163.07 |
| 99401 |
|
159 |
154 |
$48.38 |
| 80306 |
|
107 |
100 |
$31.05 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
69 |
68 |
$25.20 |
| 1159F |
|
22 |
16 |
$0.00 |
| 1160F |
|
22 |
16 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
104 |
97 |
$0.00 |
| 1126F |
|
22 |
16 |
$0.00 |
| 1170F |
|
22 |
16 |
$0.00 |