| Code | Description | Claims | Beneficiaries | Total Paid |
| Z1034 |
|
7,388 |
4,655 |
$432K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
815 |
814 |
$384K |
| Z1032 |
|
1,366 |
1,366 |
$210K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,692 |
923 |
$164K |
| Z6500 |
|
1,218 |
1,218 |
$149K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,212 |
1,093 |
$142K |
| 59514 |
|
280 |
279 |
$127K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,135 |
1,013 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,254 |
1,124 |
$57K |
| J3490 |
Unclassified drugs |
759 |
666 |
$55K |
| Z6400 |
|
4,028 |
3,515 |
$52K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
164 |
151 |
$45K |
| 76813 |
|
441 |
367 |
$42K |
| Z6406 |
|
2,125 |
1,778 |
$25K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
328 |
328 |
$20K |
| 58300 |
|
112 |
57 |
$15K |
| 99223 |
Prolong inpt eval add15 m |
244 |
235 |
$13K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,124 |
1,120 |
$12K |
| Z6204 |
|
806 |
800 |
$9K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
119 |
119 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
153 |
87 |
$8K |
| Z1038 |
|
133 |
133 |
$7K |
| 59025 |
Fetal non-stress test |
325 |
117 |
$7K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
421 |
327 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
83 |
83 |
$5K |
| 99401 |
|
379 |
257 |
$5K |
| 99000 |
|
1,613 |
1,576 |
$5K |
| 58120 |
|
43 |
27 |
$5K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
337 |
336 |
$4K |
| Z6410 |
|
262 |
163 |
$3K |
| Z6304 |
|
401 |
397 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
47 |
47 |
$3K |
| 76830 |
Ultrasound, transvaginal |
46 |
46 |
$3K |
| A4267 |
Contraceptive supply, condom, male, each |
284 |
283 |
$3K |
| 81025 |
|
856 |
849 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$2K |
| 99205 |
Prolong outpt/office vis |
26 |
26 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
24 |
24 |
$1K |
| S0197 |
Prenatal vitamins, 30-day supply |
538 |
388 |
$810.93 |
| 99222 |
Initial hospital care, per day, moderate complexity |
13 |
12 |
$786.42 |
| Z6208 |
|
66 |
66 |
$681.69 |
| 96156 |
|
26 |
25 |
$279.82 |
| 64435 |
|
27 |
27 |
$145.94 |
| 97803 |
|
12 |
12 |
$119.88 |
| Z6308 |
|
14 |
14 |
$115.07 |