| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
1,085 |
739 |
$603K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,995 |
3,305 |
$129K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,105 |
1,783 |
$106K |
| G9357 |
Post-partum screenings, evaluations and education performed |
516 |
478 |
$54K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
767 |
473 |
$22K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
364 |
200 |
$19K |
| H1000 |
Prenatal care, at-risk assessment |
210 |
154 |
$15K |
| 76801 |
|
304 |
236 |
$6K |
| 90686 |
|
316 |
282 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,312 |
2,711 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
580 |
527 |
$2K |
| 90674 |
|
102 |
90 |
$2K |
| 90715 |
|
66 |
64 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
228 |
206 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
48 |
42 |
$97.52 |
| 81025 |
|
42 |
38 |
$90.00 |
| 81002 |
|
3,807 |
2,436 |
$0.00 |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
469 |
394 |
$0.00 |
| 59426 |
|
15 |
13 |
$0.00 |
| 99024 |
|
341 |
319 |
$0.00 |
| 81000 |
|
280 |
214 |
$0.00 |