| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
6,849 |
4,146 |
$223K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,096 |
3,700 |
$88K |
| Z1034 |
|
1,450 |
889 |
$80K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,928 |
4,379 |
$73K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
300 |
298 |
$71K |
| 87797 |
|
6,134 |
5,918 |
$58K |
| 99215 |
Prolong outpt/office vis |
1,353 |
1,275 |
$46K |
| 59025 |
Fetal non-stress test |
4,482 |
1,331 |
$45K |
| 76830 |
Ultrasound, transvaginal |
1,347 |
1,331 |
$40K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
851 |
848 |
$38K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,558 |
1,509 |
$37K |
| 87480 |
|
6,128 |
5,900 |
$30K |
| 87510 |
|
6,138 |
5,914 |
$29K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
5,817 |
3,864 |
$26K |
| 96156 |
|
9,113 |
6,115 |
$25K |
| 59425 |
|
3,761 |
2,282 |
$24K |
| H1000 |
Prenatal care, at-risk assessment |
328 |
324 |
$23K |
| 81003 |
|
14,887 |
8,951 |
$19K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
6,961 |
4,695 |
$18K |
| 59430 |
|
615 |
611 |
$16K |
| 76813 |
|
283 |
266 |
$15K |
| 99401 |
|
3,682 |
2,690 |
$15K |
| Z6304 |
|
1,622 |
1,086 |
$13K |
| Z6410 |
|
1,557 |
1,044 |
$13K |
| 81025 |
|
4,081 |
3,814 |
$12K |
| 99000 |
|
7,904 |
6,463 |
$11K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
425 |
381 |
$11K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
289 |
248 |
$10K |
| G9920 |
Screening performed and negative |
618 |
611 |
$10K |
| 90715 |
|
631 |
584 |
$10K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
136 |
136 |
$9K |
| 97803 |
|
2,251 |
1,436 |
$8K |
| 96151 |
|
2,859 |
1,897 |
$7K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,053 |
1,043 |
$4K |
| Z6400 |
|
169 |
161 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
33 |
33 |
$4K |
| 76801 |
|
97 |
96 |
$3K |
| A4550 |
Surgical trays |
321 |
312 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
181 |
180 |
$2K |
| H2000 |
Comprehensive multidisciplinary evaluation |
208 |
202 |
$2K |
| Z1032 |
|
12 |
12 |
$2K |
| S9452 |
Nutrition classes, non-physician provider, per session |
634 |
627 |
$2K |
| 76826 |
|
40 |
40 |
$1K |
| 96127 |
|
1,288 |
1,282 |
$1K |
| Z6406 |
|
146 |
109 |
$1K |
| 97802 |
|
372 |
362 |
$1K |
| 90658 |
|
151 |
141 |
$956.39 |
| 96152 |
|
217 |
213 |
$834.66 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$658.34 |
| 85018 |
|
710 |
556 |
$635.45 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
16 |
$510.42 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
75 |
75 |
$429.56 |
| 99403 |
|
180 |
180 |
$300.62 |
| 96150 |
|
67 |
58 |
$287.24 |
| Z6204 |
|
18 |
13 |
$153.68 |
| Z6302 |
|
12 |
12 |
$91.60 |
| Z6202 |
|
12 |
12 |
$91.60 |
| Z6404 |
|
12 |
12 |
$91.60 |
| 76376 |
|
206 |
206 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$0.00 |