| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,278 |
910 |
$39K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
282 |
238 |
$29K |
| 99000 |
|
1,019 |
882 |
$10K |
| 76830 |
Ultrasound, transvaginal |
46 |
43 |
$4K |
| 81025 |
|
457 |
416 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
54 |
$2K |
| 81002 |
|
877 |
593 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
16 |
13 |
$886.57 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
42 |
39 |
$843.72 |
| A4558 |
Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz |
239 |
200 |
$348.06 |
| A4402 |
Lubricant, per ounce |
418 |
307 |
$222.25 |
| 99072 |
|
30 |
18 |
$0.00 |