| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,250 |
1,237 |
$221K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,335 |
1,320 |
$110K |
| 59025 |
Fetal non-stress test |
3,998 |
2,205 |
$77K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,007 |
1,449 |
$66K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
949 |
885 |
$42K |
| 76813 |
|
12 |
12 |
$2K |
| 76801 |
|
14 |
14 |
$2K |
| 76820 |
|
51 |
43 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
45 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23 |
23 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$933.45 |
| 76825 |
|
17 |
13 |
$885.43 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
18 |
18 |
$163.74 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$85.94 |