| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
169 |
150 |
$14K |
| 59025 |
Fetal non-stress test |
462 |
235 |
$12K |
| 76801 |
|
111 |
100 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
211 |
195 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
160 |
129 |
$9K |
| 59426 |
|
16 |
16 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
146 |
137 |
$5K |
| 99215 |
Prolong outpt/office vis |
60 |
54 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
70 |
31 |
$4K |
| 59425 |
|
12 |
12 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
41 |
39 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
121 |
98 |
$3K |
| 81025 |
|
208 |
185 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
61 |
51 |
$785.18 |
| 81002 |
|
151 |
141 |
$303.84 |
| 87210 |
|
18 |
15 |
$82.94 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16 |
12 |
$72.76 |
| 83986 |
|
18 |
15 |
$69.12 |