| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
291 |
193 |
$15K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
82 |
82 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
38 |
27 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
45 |
44 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
27 |
14 |
$922.53 |
| 81003 |
|
220 |
136 |
$552.43 |