| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
747 |
665 |
$24K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
411 |
354 |
$16K |
| G9012 |
Other specified case management service not elsewhere classified |
63 |
63 |
$14K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
141 |
136 |
$14K |
| 59025 |
Fetal non-stress test |
713 |
481 |
$14K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
456 |
336 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
224 |
209 |
$7K |
| 76813 |
|
169 |
163 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
65 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
66 |
45 |
$2K |
| 76820 |
|
58 |
39 |
$1K |
| 76801 |
|
18 |
18 |
$924.97 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$490.00 |