| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
12,302 |
9,128 |
$466K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,832 |
1,162 |
$102K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
741 |
506 |
$43K |
| 59430 |
|
837 |
720 |
$43K |
| 59410 |
|
31 |
24 |
$32K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
613 |
334 |
$24K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
123 |
117 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
550 |
453 |
$14K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
42 |
39 |
$3K |
| 81025 |
|
893 |
706 |
$984.43 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
24 |
24 |
$547.06 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$210.86 |
| 76820 |
|
40 |
29 |
$80.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
13 |
$18.00 |
| 3078F |
|
767 |
534 |
$12.00 |
| 1159F |
|
840 |
643 |
$0.00 |
| 3725F |
|
503 |
379 |
$0.00 |
| 1160F |
|
960 |
719 |
$0.00 |
| 3074F |
|
1,089 |
807 |
$0.00 |
| 1036F |
|
981 |
717 |
$0.00 |
| 1125F |
|
19 |
16 |
$0.00 |
| 3008F |
|
1,382 |
1,015 |
$0.00 |
| 1126F |
|
649 |
494 |
$0.00 |
| 3079F |
|
159 |
123 |
$0.00 |