| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
9,344 |
4,915 |
$526K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,336 |
3,246 |
$203K |
| 59430 |
|
1,165 |
856 |
$148K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,769 |
1,245 |
$91K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
753 |
596 |
$85K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,080 |
770 |
$65K |
| 76830 |
Ultrasound, transvaginal |
922 |
627 |
$60K |
| 59410 |
|
59 |
57 |
$58K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
206 |
185 |
$16K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
939 |
650 |
$16K |
| 59515 |
|
12 |
12 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
121 |
91 |
$11K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
126 |
66 |
$4K |
| H0049 |
Alcohol and/or drug screening |
581 |
524 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
14 |
$2K |
| 76801 |
|
13 |
13 |
$1K |
| 81025 |
|
15 |
15 |
$12.25 |