| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
334 |
325 |
$15K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
146 |
146 |
$14K |
| 95117 |
|
306 |
182 |
$8K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
94 |
94 |
$6K |
| 95886 |
|
81 |
81 |
$3K |
| 94010 |
|
53 |
53 |
$1K |
| 92567 |
|
85 |
85 |
$987.44 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
14 |
14 |
$864.49 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
53 |
53 |
$805.32 |
| 64405 |
|
12 |
12 |
$630.93 |
| 11102 |
|
13 |
13 |
$383.18 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
37 |
$381.10 |
| G0008 |
Administration of influenza virus vaccine |
21 |
21 |
$216.30 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16 |
16 |
$115.36 |
| 81025 |
|
27 |
27 |
$107.12 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
13 |
12 |
$101.97 |
| 90656 |
|
155 |
155 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
120 |
119 |
$0.00 |
| 90715 |
|
86 |
86 |
$0.00 |
| 90678 |
|
15 |
15 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
158 |
158 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
56 |
56 |
$0.00 |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
55 |
55 |
$0.00 |