| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
49 |
40 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
619 |
477 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
184 |
143 |
$12K |
| 76830 |
Ultrasound, transvaginal |
78 |
70 |
$6K |
| 99199 |
Unlisted special service, procedure or report |
1,315 |
1,159 |
$5K |
| 59425 |
|
12 |
12 |
$5K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
22 |
19 |
$3K |
| 81002 |
|
1,791 |
1,192 |
$2K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
31 |
28 |
$1K |
| 81025 |
|
160 |
141 |
$890.37 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
12 |
$716.20 |
| 99024 |
|
1,240 |
926 |
$0.00 |