| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59410 |
|
678 |
662 |
$654K |
| H1000 |
Prenatal care, at-risk assessment |
9,439 |
5,866 |
$586K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,093 |
1,053 |
$176K |
| 59430 |
|
1,569 |
1,251 |
$171K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
954 |
861 |
$80K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
808 |
791 |
$79K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,822 |
1,435 |
$78K |
| 99220 |
|
430 |
365 |
$60K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
663 |
376 |
$32K |
| 76801 |
|
329 |
311 |
$29K |
| 59515 |
|
28 |
24 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
226 |
196 |
$19K |
| 99219 |
|
127 |
117 |
$12K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
119 |
118 |
$11K |
| 99218 |
|
53 |
44 |
$3K |
| 59025 |
Fetal non-stress test |
129 |
95 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
35 |
35 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
14 |
14 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
49 |
49 |
$934.45 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$692.59 |
| 36415 |
Collection of venous blood by venipuncture |
253 |
234 |
$251.32 |
| 81025 |
|
115 |
113 |
$134.11 |
| 84703 |
|
14 |
14 |
$0.00 |