| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
4,717 |
3,043 |
$204K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
533 |
530 |
$42K |
| 99385 |
|
298 |
296 |
$29K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
442 |
321 |
$28K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
14 |
14 |
$11K |
| 59426 |
|
12 |
12 |
$11K |
| 76801 |
|
156 |
154 |
$10K |
| 99205 |
Prolong outpt/office vis |
82 |
82 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
105 |
101 |
$5K |
| 99215 |
Prolong outpt/office vis |
42 |
41 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
15 |
14 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$817.79 |
| 36415 |
Collection of venous blood by venipuncture |
54 |
53 |
$140.40 |
| 81025 |
|
13 |
13 |
$92.69 |