| Code | Description | Claims | Beneficiaries | Total Paid |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
421 |
236 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
276 |
243 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
187 |
174 |
$5K |
| 59425 |
|
37 |
27 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$582.43 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17 |
17 |
$244.37 |
| 81025 |
|
62 |
59 |
$159.60 |