| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,302 |
1,120 |
$86K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,505 |
1,167 |
$68K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
165 |
121 |
$8K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
482 |
456 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
18 |
12 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
17 |
12 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
21 |
12 |
$1K |