| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
24,983 |
19,440 |
$1.28M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13,031 |
11,647 |
$980K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
3,088 |
2,900 |
$393K |
| 76830 |
Ultrasound, transvaginal |
2,113 |
1,949 |
$207K |
| 76813 |
|
2,787 |
2,642 |
$192K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,776 |
1,677 |
$160K |
| 76818 |
|
1,592 |
869 |
$129K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
5,391 |
4,728 |
$123K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,398 |
2,746 |
$117K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
832 |
706 |
$94K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,261 |
1,577 |
$84K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,857 |
2,338 |
$83K |
| 59515 |
|
72 |
66 |
$78K |
| 59410 |
|
78 |
66 |
$64K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,282 |
2,103 |
$41K |
| 59025 |
Fetal non-stress test |
2,645 |
1,603 |
$36K |
| 99233 |
Prolong inpt eval add15 m |
557 |
238 |
$34K |
| 99215 |
Prolong outpt/office vis |
454 |
381 |
$32K |
| 76801 |
|
235 |
219 |
$29K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
379 |
282 |
$25K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
249 |
191 |
$16K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
604 |
249 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
832 |
724 |
$16K |
| 99243 |
|
378 |
361 |
$16K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
19 |
14 |
$14K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
255 |
125 |
$12K |
| 99222 |
Initial hospital care, per day, moderate complexity |
58 |
52 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
154 |
132 |
$5K |
| 46606 |
|
221 |
175 |
$5K |
| 59430 |
|
144 |
130 |
$5K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
29 |
29 |
$5K |
| 99205 |
Prolong outpt/office vis |
26 |
26 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
67 |
62 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$1K |
| 81025 |
|
688 |
461 |
$1K |
| 99385 |
|
13 |
12 |
$997.97 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$850.23 |
| 81002 |
|
62 |
53 |
$374.84 |
| 11981 |
|
16 |
12 |
$331.17 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
24 |
$134.44 |
| 1126F |
|
685 |
565 |
$19.18 |
| 87210 |
|
12 |
12 |
$3.84 |
| 1111F |
|
34 |
28 |
$0.03 |