| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
23,393 |
10,879 |
$1.11M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,202 |
11,835 |
$832K |
| 59410 |
|
678 |
656 |
$767K |
| 76830 |
Ultrasound, transvaginal |
8,038 |
5,743 |
$519K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,613 |
1,217 |
$311K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
327 |
274 |
$286K |
| 59515 |
|
201 |
196 |
$283K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,005 |
2,974 |
$273K |
| 59430 |
|
1,687 |
1,246 |
$208K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,551 |
1,855 |
$148K |
| 99385 |
|
1,233 |
1,063 |
$105K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,709 |
1,089 |
$104K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
6,808 |
4,849 |
$97K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,679 |
1,143 |
$97K |
| 99386 |
|
572 |
564 |
$72K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
767 |
735 |
$67K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
671 |
479 |
$43K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,791 |
1,298 |
$37K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
157 |
157 |
$18K |
| 88142 |
|
1,928 |
864 |
$13K |
| 81025 |
|
9,075 |
6,518 |
$12K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
181 |
158 |
$11K |
| 76801 |
|
457 |
405 |
$11K |
| 76813 |
|
457 |
407 |
$9K |
| 58300 |
|
338 |
283 |
$8K |
| 80055 |
|
556 |
330 |
$6K |
| 58301 |
|
66 |
66 |
$6K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
12 |
12 |
$4K |
| 87081 |
|
2,594 |
1,488 |
$3K |
| 87110 |
|
1,761 |
689 |
$3K |
| 57454 |
|
13 |
13 |
$2K |
| 99403 |
|
13 |
13 |
$812.72 |
| 99459 |
|
299 |
284 |
$711.59 |
| 0503F |
|
264 |
253 |
$200.00 |
| 81002 |
|
44 |
37 |
$34.34 |