| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81003 |
|
7,904 |
3,038 |
$3K |
| G9357 |
Post-partum screenings, evaluations and education performed |
30 |
12 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
26 |
12 |
$664.95 |
| 90686 |
|
43 |
27 |
$437.69 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
20 |
13 |
$156.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21 |
13 |
$127.90 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
16 |
$67.05 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
15 |
$55.00 |
| 96161 |
|
25 |
12 |
$23.52 |
| 0502F |
|
106 |
64 |
$0.00 |