| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
329 |
328 |
$43K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
156 |
156 |
$35K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,257 |
807 |
$14K |
| 99215 |
Prolong outpt/office vis |
316 |
316 |
$8K |
| 59025 |
Fetal non-stress test |
3,540 |
1,692 |
$6K |
| 59425 |
|
401 |
262 |
$6K |
| Z1034 |
|
71 |
40 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,125 |
1,095 |
$3K |
| H1000 |
Prenatal care, at-risk assessment |
473 |
472 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
258 |
258 |
$3K |
| J3490 |
Unclassified drugs |
127 |
126 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
779 |
776 |
$3K |
| Z1032 |
|
12 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
96 |
96 |
$283.18 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$0.00 |
| 90674 |
|
18 |
18 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
19 |
$0.00 |