| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
2,231 |
2,194 |
$4.72M |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
480 |
437 |
$437K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,793 |
5,202 |
$406K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,834 |
3,225 |
$382K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,780 |
2,381 |
$303K |
| 76801 |
|
2,515 |
2,221 |
$244K |
| 76830 |
Ultrasound, transvaginal |
2,298 |
1,960 |
$232K |
| 76813 |
|
2,096 |
1,976 |
$226K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,268 |
1,223 |
$216K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,283 |
1,180 |
$96K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,266 |
1,032 |
$91K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,625 |
1,997 |
$83K |
| 59426 |
|
120 |
63 |
$80K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
763 |
652 |
$59K |
| 59430 |
|
277 |
263 |
$59K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
616 |
587 |
$55K |
| 90715 |
|
960 |
921 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
247 |
245 |
$36K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
438 |
434 |
$31K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
210 |
206 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,085 |
1,024 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
189 |
153 |
$12K |
| 58300 |
|
133 |
131 |
$12K |
| 99502 |
|
167 |
120 |
$8K |
| 59425 |
|
22 |
12 |
$8K |
| 99441 |
|
234 |
139 |
$6K |
| 99350 |
Prolong home eval add 15m |
47 |
30 |
$3K |
| S9436 |
Childbirth preparation/lamaze classes, non-physician provider, per session |
114 |
67 |
$2K |
| 96160 |
|
1,157 |
1,002 |
$2K |
| 99463 |
|
49 |
38 |
$2K |
| 90674 |
|
81 |
81 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
26 |
$2K |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
140 |
95 |
$1K |
| 81002 |
|
453 |
413 |
$888.12 |
| 96161 |
|
29 |
28 |
$43.40 |
| H1000 |
Prenatal care, at-risk assessment |
1,154 |
1,004 |
$12.50 |
| 94760 |
|
33 |
26 |
$2.00 |
| 0503F |
|
1,796 |
1,751 |
$0.00 |
| 0500F |
|
1,703 |
1,678 |
$0.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
23 |
13 |
$0.00 |
| 0502F |
|
8,718 |
6,329 |
$0.00 |