| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59425 |
|
366 |
240 |
$27K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
151 |
127 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
135 |
120 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
77 |
74 |
$3K |
| 99205 |
Prolong outpt/office vis |
19 |
17 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
26 |
25 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$1K |
| 80050 |
General health panel |
29 |
29 |
$1K |
| 84481 |
|
73 |
69 |
$1K |
| 76830 |
Ultrasound, transvaginal |
14 |
13 |
$984.27 |
| 59430 |
|
12 |
12 |
$892.08 |
| 87510 |
|
53 |
49 |
$851.96 |
| 87660 |
|
37 |
33 |
$567.22 |
| 84443 |
Thyroid stimulating hormone (TSH) |
43 |
41 |
$563.88 |
| 87480 |
|
37 |
33 |
$562.44 |
| 84439 |
|
73 |
69 |
$528.45 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
38 |
38 |
$330.46 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
43 |
42 |
$262.78 |
| 80053 |
Comprehensive metabolic panel |
15 |
15 |
$207.68 |
| 81025 |
|
46 |
43 |
$128.80 |
| 87210 |
|
32 |
31 |
$91.91 |
| 81002 |
|
134 |
100 |
$1.72 |
| 36415 |
Collection of venous blood by venipuncture |
43 |
38 |
$0.00 |