| Code | Short Description | Long Description |
| 76802 | HC US PG UTER F&MAT 14 WK TABDL EA GESTATION | |
| 76805 | HC US PG UTER F&MAT AFTER 1ST TRI 1/1ST GESTATION | |
| 76810 | HC US PG UTER F&MAT AFTER 1ST TRI ABDL EA GESTATION | |
| 76811 | HC US PG UTER F&MAT DETAILED FTL XM 1ST GESTATION | |
| 76812 | HC US PG UTER F&MAT DETAILED FTL ANTMC XM EA |