| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,167 |
1,930 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
738 |
671 |
$7K |
| 59025 |
Fetal non-stress test |
1,775 |
692 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
162 |
126 |
$4K |
| Z6410 |
|
483 |
282 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
442 |
383 |
$3K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
2,449 |
1,605 |
$3K |
| Z6304 |
|
402 |
248 |
$3K |
| Z6204 |
|
392 |
244 |
$3K |
| Z6406 |
|
392 |
244 |
$3K |
| 97803 |
|
5,333 |
3,444 |
$3K |
| 99401 |
|
5,325 |
3,439 |
$3K |
| 59425 |
|
218 |
119 |
$3K |
| 96151 |
|
1,655 |
1,133 |
$2K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
5,384 |
2,980 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
28 |
28 |
$1K |
| 96156 |
|
4,176 |
2,755 |
$993.35 |
| H2000 |
Comprehensive multidisciplinary evaluation |
249 |
238 |
$985.57 |
| 87510 |
|
1,011 |
896 |
$934.58 |
| 87660 |
|
1,007 |
892 |
$929.58 |
| 87480 |
|
1,011 |
896 |
$851.18 |
| 81003 |
|
2,897 |
2,253 |
$800.04 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
253 |
248 |
$611.25 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$568.40 |
| H1000 |
Prenatal care, at-risk assessment |
221 |
218 |
$227.36 |
| 83986 |
|
215 |
147 |
$66.94 |
| S9452 |
Nutrition classes, non-physician provider, per session |
241 |
224 |
$22.71 |
| 96152 |
|
57 |
51 |
$7.57 |
| 59430 |
|
79 |
75 |
$0.00 |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
40 |
39 |
$0.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
121 |
63 |
$0.00 |