| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
660 |
579 |
$25K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
141 |
106 |
$10K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
107 |
86 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$928.03 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15 |
12 |
$819.18 |
| 81025 |
|
58 |
55 |
$439.11 |
| 90686 |
|
12 |
12 |
$228.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$75.40 |
| 0502F |
|
170 |
146 |
$0.47 |