| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,403 |
950 |
$85K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
774 |
560 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,273 |
936 |
$33K |
| 59426 |
|
49 |
46 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
654 |
471 |
$21K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
18 |
15 |
$19K |
| 76830 |
Ultrasound, transvaginal |
427 |
306 |
$17K |
| 76818 |
|
87 |
42 |
$7K |
| 81025 |
|
954 |
782 |
$6K |
| 59025 |
Fetal non-stress test |
287 |
179 |
$6K |
| 76801 |
|
41 |
38 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
19 |
17 |
$2K |
| 85018 |
|
770 |
637 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
110 |
64 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
75 |
59 |
$665.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
14 |
$646.88 |
| 81003 |
|
494 |
296 |
$580.17 |
| J3490 |
Unclassified drugs |
67 |
28 |
$4.30 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
64 |
35 |
$0.53 |
| 90658 |
|
57 |
40 |
$0.00 |