| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,550 |
1,153 |
$118K |
| 59425 |
|
988 |
715 |
$74K |
| H1000 |
Prenatal care, at-risk assessment |
29 |
29 |
$5K |
| 59430 |
|
58 |
55 |
$4K |
| 96127 |
|
157 |
154 |
$1K |
| 99000 |
|
222 |
206 |
$747.78 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
184 |
174 |
$585.00 |
| 90715 |
|
13 |
12 |
$500.76 |
| 90686 |
|
13 |
13 |
$305.37 |
| 59025 |
Fetal non-stress test |
15 |
13 |
$231.39 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
40 |
$209.52 |
| 3074F |
|
182 |
154 |
$0.00 |
| 3079F |
|
16 |
13 |
$0.00 |
| 3078F |
|
154 |
133 |
$0.00 |