| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
1,083 |
813 |
$2K |
| 99215 |
Prolong outpt/office vis |
151 |
151 |
$543.33 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
637 |
602 |
$307.55 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
465 |
444 |
$213.84 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
357 |
269 |
$116.62 |
| 76801 |
|
89 |
89 |
$77.64 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60 |
60 |
$74.24 |
| 88141 |
|
158 |
158 |
$62.52 |
| 99000 |
|
509 |
487 |
$43.08 |
| 81025 |
|
692 |
662 |
$38.78 |
| 81002 |
|
513 |
422 |
$31.95 |
| 82947 |
|
193 |
177 |
$13.08 |
| S0197 |
Prenatal vitamins, 30-day supply |
324 |
295 |
$0.00 |
| 59430 |
|
33 |
32 |
$0.00 |