| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
3,339 |
1,788 |
$201K |
| 59410 |
|
99 |
99 |
$80K |
| 81025 |
|
576 |
567 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,149 |
1,032 |
$37K |
| 76830 |
Ultrasound, transvaginal |
326 |
325 |
$20K |
| 59430 |
|
311 |
260 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
245 |
245 |
$13K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
133 |
133 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
87 |
87 |
$6K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
376 |
364 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
56 |
56 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$3K |
| 76801 |
|
63 |
62 |
$3K |
| 87210 |
|
1,155 |
1,129 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$2K |
| 76818 |
|
17 |
16 |
$944.82 |
| 99385 |
|
14 |
12 |
$900.48 |
| 59025 |
Fetal non-stress test |
1,117 |
550 |
$249.22 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
46 |
46 |
$0.00 |