| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
366 |
335 |
$427K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
2,707 |
2,591 |
$125K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,049 |
897 |
$121K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
290 |
250 |
$10K |
| 59410 |
|
13 |
12 |
$8K |
| 59025 |
Fetal non-stress test |
279 |
251 |
$6K |
| 76801 |
|
120 |
106 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$946.68 |
| 99218 |
|
12 |
12 |
$795.87 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
13 |
$381.12 |
| 0500F |
|
545 |
523 |
$0.00 |