| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,789 |
2,083 |
$191K |
| 59425 |
|
1,495 |
1,056 |
$97K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,252 |
2,153 |
$62K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
998 |
961 |
$45K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
543 |
376 |
$33K |
| 76857 |
|
764 |
758 |
$24K |
| 59430 |
|
119 |
119 |
$8K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$7K |
| H1000 |
Prenatal care, at-risk assessment |
50 |
49 |
$6K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
148 |
146 |
$5K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$2K |
| 99000 |
|
314 |
299 |
$1K |
| 59025 |
Fetal non-stress test |
35 |
12 |
$806.12 |
| 90686 |
|
24 |
24 |
$599.11 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
24 |
$22.30 |