| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
619 |
619 |
$52K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,428 |
1,372 |
$45K |
| 99243 |
|
338 |
338 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
520 |
486 |
$10K |
| 93325 |
|
165 |
157 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
348 |
339 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
95 |
94 |
$4K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
59 |
59 |
$3K |
| 93000 |
|
95 |
93 |
$2K |
| 76813 |
|
34 |
34 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
63 |
63 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
31 |
29 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
45 |
43 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$848.88 |
| 99242 |
|
37 |
37 |
$778.80 |
| 99241 |
|
14 |
14 |
$600.59 |
| 88304 |
|
51 |
49 |
$548.55 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$343.70 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
842 |
838 |
$178.40 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$90.21 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12 |
12 |
$0.00 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26 |
26 |
$0.00 |
| 93304 |
|
12 |
12 |
$0.00 |