| Code | Description | Claims | Beneficiaries | Total Paid |
| H1000 |
Prenatal care, at-risk assessment |
25,686 |
16,475 |
$1.74M |
| 59410 |
|
997 |
919 |
$972K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,976 |
12,614 |
$687K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,333 |
3,170 |
$271K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,367 |
3,050 |
$265K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,587 |
2,512 |
$247K |
| 76830 |
Ultrasound, transvaginal |
2,858 |
2,746 |
$223K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,025 |
973 |
$187K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
818 |
751 |
$109K |
| 76801 |
|
1,004 |
963 |
$89K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
739 |
708 |
$84K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,194 |
1,134 |
$84K |
| 59515 |
|
43 |
43 |
$53K |
| 99385 |
|
352 |
342 |
$37K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
250 |
231 |
$23K |
| 81025 |
|
6,889 |
6,351 |
$20K |
| 57454 |
|
93 |
89 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
510 |
487 |
$7K |
| 59025 |
Fetal non-stress test |
125 |
62 |
$6K |
| 76857 |
|
149 |
142 |
$5K |
| 57465 |
|
92 |
91 |
$3K |
| 58300 |
|
57 |
52 |
$3K |
| 76818 |
|
24 |
12 |
$2K |
| 99235 |
|
13 |
12 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
27 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
17 |
16 |
$982.78 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31 |
25 |
$388.11 |
| 90658 |
|
66 |
66 |
$84.90 |
| 0503F |
|
12 |
12 |
$0.00 |