| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
1,185 |
676 |
$75K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
112 |
22 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
319 |
256 |
$25K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
171 |
93 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
38 |
24 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
71 |
68 |
$3K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
16 |
15 |
$2K |
| 99215 |
Prolong outpt/office vis |
27 |
25 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40 |
29 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
20 |
19 |
$888.49 |