| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59410 |
|
738 |
692 |
$682K |
| H1000 |
Prenatal care, at-risk assessment |
7,569 |
4,960 |
$471K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,131 |
1,082 |
$179K |
| 59430 |
|
1,388 |
1,096 |
$173K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,644 |
1,331 |
$131K |
| 59515 |
|
114 |
107 |
$114K |
| 99223 |
Prolong inpt eval add15 m |
704 |
552 |
$99K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,033 |
868 |
$78K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
822 |
786 |
$74K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,207 |
842 |
$46K |
| 99220 |
|
249 |
220 |
$39K |
| 76801 |
|
496 |
478 |
$38K |
| 59025 |
Fetal non-stress test |
1,201 |
892 |
$26K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
154 |
152 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
367 |
312 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
54 |
53 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
13 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
27 |
19 |
$964.05 |
| 99218 |
|
14 |
14 |
$960.96 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
19 |
16 |
$438.68 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
12 |
$0.00 |