| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
11,741 |
5,188 |
$489K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,056 |
1,164 |
$89K |
| 59430 |
|
633 |
469 |
$67K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
787 |
650 |
$49K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
690 |
566 |
$41K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
997 |
728 |
$35K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
684 |
342 |
$31K |
| 59515 |
|
31 |
28 |
$31K |
| 76830 |
Ultrasound, transvaginal |
444 |
344 |
$29K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
256 |
174 |
$27K |
| 59410 |
|
25 |
25 |
$25K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
314 |
263 |
$22K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
408 |
240 |
$22K |
| 81025 |
|
3,716 |
2,500 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
36 |
36 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
86 |
64 |
$3K |
| 99385 |
|
15 |
15 |
$2K |
| 81002 |
|
2,892 |
1,800 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
88 |
73 |
$2K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17 |
12 |
$2K |
| 99234 |
|
15 |
13 |
$2K |
| 76857 |
|
82 |
63 |
$811.35 |
| 59025 |
Fetal non-stress test |
82 |
63 |
$792.00 |
| 81003 |
|
2,136 |
565 |
$49.52 |
| 36415 |
Collection of venous blood by venipuncture |
31 |
26 |
$5.00 |
| 1036F |
|
1,760 |
1,288 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
991 |
730 |
$0.00 |
| G8432 |
Depression screening not documented, reason not given |
14 |
13 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
113 |
74 |
$0.00 |
| 0503F |
|
61 |
58 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
27 |
19 |
$0.00 |
| 3008F |
|
54 |
51 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,860 |
1,344 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
975 |
718 |
$0.00 |