| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,526 |
1,247 |
$188K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,251 |
1,837 |
$131K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,528 |
1,313 |
$58K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
765 |
591 |
$49K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
476 |
205 |
$33K |
| 76830 |
Ultrasound, transvaginal |
458 |
448 |
$31K |
| 59025 |
Fetal non-stress test |
1,031 |
323 |
$29K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
316 |
310 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
209 |
208 |
$20K |
| H1000 |
Prenatal care, at-risk assessment |
106 |
105 |
$15K |
| 99000 |
|
3,954 |
2,437 |
$14K |
| 81002 |
|
2,607 |
1,391 |
$6K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
26 |
26 |
$4K |
| 76813 |
|
39 |
37 |
$4K |
| 59430 |
|
30 |
29 |
$3K |
| Z1034 |
|
42 |
25 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
145 |
144 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
75 |
73 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
13 |
$1K |
| 99070 |
|
95 |
90 |
$23.46 |
| A4550 |
Surgical trays |
29 |
29 |
$0.00 |