| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
4,588 |
2,827 |
$276K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
234 |
234 |
$128K |
| 99205 |
Prolong outpt/office vis |
1,011 |
1,003 |
$81K |
| H1000 |
Prenatal care, at-risk assessment |
420 |
415 |
$53K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
488 |
477 |
$43K |
| 99215 |
Prolong outpt/office vis |
599 |
583 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
543 |
502 |
$19K |
| 59425 |
|
191 |
120 |
$12K |
| 59430 |
|
146 |
140 |
$9K |
| 59514 |
|
12 |
12 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
82 |
82 |
$5K |
| 76830 |
Ultrasound, transvaginal |
63 |
63 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
70 |
67 |
$2K |
| 76801 |
|
14 |
14 |
$1K |
| 88150 |
|
113 |
112 |
$287.50 |
| 99000 |
|
77 |
76 |
$243.21 |
| A4550 |
Surgical trays |
14 |
13 |
$0.00 |