| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
4,028 |
2,694 |
$257K |
| 59430 |
|
485 |
450 |
$69K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,192 |
1,047 |
$49K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
625 |
569 |
$46K |
| 59410 |
|
41 |
40 |
$44K |
| 76830 |
Ultrasound, transvaginal |
555 |
512 |
$38K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
186 |
168 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
338 |
321 |
$23K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
255 |
247 |
$22K |
| 76801 |
|
130 |
125 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
136 |
132 |
$10K |
| 59025 |
Fetal non-stress test |
140 |
82 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
85 |
85 |
$7K |
| 81025 |
|
624 |
585 |
$3K |
| 99385 |
|
26 |
25 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
39 |
35 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
36 |
27 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
123 |
82 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
86 |
75 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
12 |
$248.59 |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
20 |
19 |
$0.00 |