| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
91 |
80 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
144 |
116 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
64 |
53 |
$3K |
| 0502F |
|
160 |
116 |
$310.00 |
| 0501F |
|
70 |
54 |
$140.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
27 |
$132.52 |
| 81025 |
|
15 |
12 |
$63.90 |
| 85018 |
|
26 |
26 |
$45.32 |
| 0500F |
|
65 |
52 |
$20.00 |
| 0503F |
|
79 |
66 |
$0.00 |
| 3292F |
|
14 |
13 |
$0.00 |
| 3294F |
|
14 |
13 |
$0.00 |
| 3754F |
|
14 |
13 |
$0.00 |