| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
18,786 |
14,045 |
$1.13M |
| 59425 |
|
4,496 |
2,802 |
$217K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
304 |
303 |
$177K |
| 59025 |
Fetal non-stress test |
8,402 |
5,005 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,834 |
1,788 |
$71K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
345 |
338 |
$19K |
| Z1034 |
|
336 |
221 |
$19K |
| H1000 |
Prenatal care, at-risk assessment |
146 |
146 |
$19K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
369 |
312 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
523 |
493 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
452 |
335 |
$12K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
235 |
189 |
$7K |
| 59514 |
|
14 |
14 |
$6K |
| 76801 |
|
139 |
139 |
$5K |
| 99223 |
Prolong inpt eval add15 m |
50 |
50 |
$5K |
| 99222 |
Initial hospital care, per day, moderate complexity |
53 |
52 |
$4K |
| 99215 |
Prolong outpt/office vis |
26 |
26 |
$3K |
| 59430 |
|
41 |
39 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$2K |
| 99221 |
|
33 |
32 |
$1K |
| 99242 |
|
29 |
29 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$959.04 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
13 |
13 |
$846.56 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
16 |
$692.62 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$364.80 |
| 71045 |
Radiologic examination, chest; single view |
41 |
38 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
183 |
167 |
$0.00 |