| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
33,320 |
19,363 |
$1.89M |
| 59515 |
|
1,677 |
1,537 |
$1.60M |
| 59410 |
|
794 |
778 |
$782K |
| 59430 |
|
5,392 |
4,129 |
$504K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,687 |
2,602 |
$430K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
344 |
341 |
$296K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,548 |
6,691 |
$293K |
| 59514 |
|
275 |
272 |
$258K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,948 |
1,925 |
$157K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,549 |
1,507 |
$96K |
| 76801 |
|
1,031 |
1,015 |
$82K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
78 |
78 |
$75K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
472 |
462 |
$40K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
568 |
561 |
$40K |
| 99385 |
|
453 |
444 |
$36K |
| 57454 |
|
295 |
295 |
$36K |
| 99219 |
|
375 |
292 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
285 |
281 |
$14K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
12 |
12 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
282 |
262 |
$9K |
| 58300 |
|
315 |
309 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
90 |
86 |
$8K |
| 99386 |
|
48 |
48 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
31 |
$3K |
| 76857 |
|
212 |
210 |
$3K |
| 99442 |
|
175 |
163 |
$2K |
| 99221 |
|
19 |
13 |
$1K |
| 59025 |
Fetal non-stress test |
48 |
44 |
$927.85 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$680.03 |