| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76830 |
Ultrasound, transvaginal |
1,216 |
1,206 |
$100K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,123 |
1,113 |
$84K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,230 |
1,175 |
$67K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
435 |
435 |
$40K |
| 76801 |
|
164 |
155 |
$14K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
362 |
362 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
133 |
118 |
$12K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
38 |
38 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
66 |
64 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
84 |
84 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
71 |
69 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
27 |
$2K |
| 76813 |
|
12 |
12 |
$1K |
| 90674 |
|
12 |
12 |
$358.83 |
| 87210 |
|
84 |
82 |
$342.92 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$308.88 |
| 81025 |
|
13 |
13 |
$79.15 |
| 81002 |
|
24 |
24 |
$51.24 |