| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
48 |
46 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
33 |
29 |
$2K |
| 90674 |
|
58 |
54 |
$1K |
| 90715 |
|
26 |
25 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
24 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
147 |
132 |
$609.39 |
| 80305 |
|
15 |
13 |
$170.50 |
| 0502F |
|
362 |
285 |
$140.00 |
| 0501F |
|
228 |
169 |
$140.00 |
| 82950 |
|
24 |
24 |
$135.80 |
| 85018 |
|
14 |
14 |
$36.99 |
| 0503F |
|
158 |
141 |
$33.94 |
| 0500F |
|
139 |
118 |
$33.94 |
| 3754F |
|
58 |
50 |
$0.00 |
| 3292F |
|
61 |
49 |
$0.00 |
| 3294F |
|
59 |
49 |
$0.00 |