| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
5,602 |
2,854 |
$303K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
290 |
245 |
$28K |
| 59515 |
|
26 |
26 |
$25K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
146 |
126 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
407 |
332 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
210 |
178 |
$8K |
| 76830 |
Ultrasound, transvaginal |
88 |
82 |
$8K |
| 99385 |
|
76 |
71 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
102 |
92 |
$3K |
| 99386 |
|
12 |
12 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$837.75 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
749 |
595 |
$319.27 |