| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
253 |
183 |
$26K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
187 |
177 |
$6K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
86 |
75 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
33 |
29 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
57 |
50 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
38 |
37 |
$931.67 |
| 59025 |
Fetal non-stress test |
107 |
78 |
$882.90 |