| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
7,878 |
4,242 |
$423K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,487 |
1,075 |
$78K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
412 |
275 |
$66K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
639 |
546 |
$51K |
| 59515 |
|
47 |
25 |
$41K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
836 |
688 |
$29K |
| 59410 |
|
30 |
29 |
$29K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
496 |
288 |
$25K |
| 59430 |
|
378 |
244 |
$20K |
| 76830 |
Ultrasound, transvaginal |
252 |
238 |
$20K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
265 |
189 |
$18K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
397 |
150 |
$16K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
119 |
93 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
494 |
411 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
292 |
146 |
$3K |
| 99385 |
|
39 |
37 |
$2K |
| 81025 |
|
2,321 |
1,859 |
$2K |
| 59025 |
Fetal non-stress test |
335 |
181 |
$916.42 |
| 81002 |
|
3,550 |
2,256 |
$304.46 |
| 76801 |
|
12 |
12 |
$303.56 |
| 76857 |
|
79 |
76 |
$194.98 |
| 81003 |
|
842 |
272 |
$74.74 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,275 |
1,107 |
$0.01 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
49 |
37 |
$0.00 |
| 1036F |
|
1,241 |
1,058 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
724 |
619 |
$0.00 |
| G8432 |
Depression screening not documented, reason not given |
67 |
59 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
14 |
$0.00 |
| 0503F |
|
35 |
27 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
493 |
431 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
12 |
12 |
$0.00 |