| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
751 |
669 |
$879K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,771 |
5,950 |
$350K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,621 |
3,492 |
$332K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,403 |
1,079 |
$173K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,586 |
1,386 |
$160K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
2,907 |
2,337 |
$120K |
| 76801 |
|
1,163 |
1,010 |
$106K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,171 |
955 |
$105K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,098 |
879 |
$84K |
| 99199 |
Unlisted special service, procedure or report |
19,450 |
19,007 |
$60K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,678 |
2,184 |
$42K |
| 99215 |
Prolong outpt/office vis |
424 |
352 |
$21K |
| 81025 |
|
2,668 |
2,138 |
$17K |
| 87210 |
|
3,497 |
2,672 |
$13K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
206 |
154 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
616 |
409 |
$10K |
| 59426 |
|
13 |
13 |
$8K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
12 |
$8K |
| 76830 |
Ultrasound, transvaginal |
110 |
85 |
$6K |
| 81002 |
|
115 |
70 |
$218.18 |