| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,366 |
878 |
$54K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,004 |
827 |
$32K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
511 |
290 |
$23K |
| 76830 |
Ultrasound, transvaginal |
299 |
247 |
$14K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
231 |
152 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
36 |
$2K |
| 76818 |
|
55 |
12 |
$2K |
| 59025 |
Fetal non-stress test |
107 |
71 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
183 |
133 |
$1K |
| 90715 |
|
14 |
13 |
$653.75 |
| 90686 |
|
48 |
30 |
$601.59 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$279.90 |
| 90658 |
|
16 |
14 |
$254.15 |
| 81025 |
|
12 |
12 |
$69.92 |
| 96160 |
|
14 |
12 |
$33.77 |
| 81003 |
|
13 |
12 |
$12.26 |
| 0501F |
|
43 |
24 |
$0.00 |
| 0502F |
|
394 |
212 |
$0.00 |