| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
808 |
432 |
$48K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
413 |
307 |
$9K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
36 |
35 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
127 |
100 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
176 |
142 |
$4K |
| 59430 |
|
83 |
66 |
$4K |
| 99219 |
|
18 |
14 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$907.29 |
| 76818 |
|
20 |
13 |
$860.20 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
22 |
16 |
$516.73 |
| 81025 |
|
81 |
64 |
$339.17 |
| 76801 |
|
17 |
17 |
$155.96 |
| 59025 |
Fetal non-stress test |
22 |
15 |
$144.05 |
| 82947 |
|
48 |
35 |
$40.33 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
19 |
17 |
$0.00 |