| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
686 |
420 |
$40K |
| 76827 |
|
180 |
156 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
75 |
69 |
$7K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
48 |
41 |
$6K |
| 93325 |
|
124 |
109 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
27 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
23 |
12 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
19 |
14 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
16 |
13 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
16 |
12 |
$955.53 |
| 81003 |
|
194 |
87 |
$199.99 |