| Code | Description | Claims | Beneficiaries | Total Paid |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
4,020 |
2,115 |
$257K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,166 |
3,554 |
$171K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,842 |
1,456 |
$90K |
| 59425 |
|
1,372 |
773 |
$85K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,131 |
490 |
$62K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
894 |
869 |
$61K |
| 59025 |
Fetal non-stress test |
2,154 |
730 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,763 |
1,594 |
$46K |
| 76830 |
Ultrasound, transvaginal |
631 |
628 |
$43K |
| 99215 |
Prolong outpt/office vis |
564 |
547 |
$39K |
| H1000 |
Prenatal care, at-risk assessment |
225 |
223 |
$30K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
130 |
127 |
$21K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
184 |
182 |
$19K |
| 99000 |
|
7,988 |
5,070 |
$14K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
14 |
13 |
$8K |
| 76813 |
|
66 |
64 |
$7K |
| 81002 |
|
6,408 |
3,604 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
42 |
40 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
35 |
29 |
$3K |
| 59430 |
|
27 |
27 |
$2K |
| 76801 |
|
13 |
12 |
$961.22 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$824.89 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
96 |
80 |
$759.55 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
39 |
39 |
$438.48 |
| 99070 |
|
485 |
461 |
$417.17 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16 |
12 |
$300.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$256.07 |
| A4550 |
Surgical trays |
668 |
631 |
$46.00 |
| 82950 |
|
38 |
38 |
$30.41 |