| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
15,920 |
12,299 |
$935K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,041 |
905 |
$188K |
| 59410 |
|
118 |
110 |
$112K |
| 59430 |
|
1,702 |
1,499 |
$93K |
| 59025 |
Fetal non-stress test |
1,221 |
753 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
293 |
258 |
$16K |
| 59515 |
|
15 |
13 |
$13K |
| 76813 |
|
363 |
329 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
249 |
221 |
$10K |
| 76801 |
|
437 |
381 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
360 |
302 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
161 |
133 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
117 |
82 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
13 |
$510.49 |
| 90688 |
|
52 |
42 |
$408.87 |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
230 |
178 |
$393.58 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
30 |
$40.00 |