| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
7,384 |
6,214 |
$477K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,954 |
2,782 |
$213K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,840 |
1,780 |
$112K |
| 59430 |
|
678 |
595 |
$102K |
| 59410 |
|
133 |
124 |
$80K |
| 59515 |
|
79 |
69 |
$79K |
| 76830 |
Ultrasound, transvaginal |
889 |
861 |
$75K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
861 |
828 |
$74K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
251 |
248 |
$55K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
555 |
523 |
$38K |
| 76818 |
|
245 |
216 |
$23K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
351 |
328 |
$23K |
| 59025 |
Fetal non-stress test |
762 |
708 |
$19K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
34 |
32 |
$4K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
67 |
55 |
$3K |
| 81025 |
|
852 |
807 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
205 |
202 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
29 |
$3K |
| 76801 |
|
34 |
32 |
$3K |
| 59514 |
|
32 |
29 |
$3K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
92 |
87 |
$2K |
| 99459 |
|
905 |
709 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
45 |
45 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
20 |
20 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
17 |
17 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
28 |
28 |
$1K |
| 81002 |
|
716 |
666 |
$892.04 |
| 96160 |
|
400 |
317 |
$335.40 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
17 |
17 |
$277.82 |
| 85018 |
|
73 |
65 |
$79.81 |
| 0500F |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
50 |
41 |
$0.00 |
| 96127 |
|
36 |
30 |
$0.00 |