| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
454 |
393 |
$28K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
161 |
116 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
39 |
38 |
$4K |
| 76830 |
Ultrasound, transvaginal |
25 |
25 |
$3K |
| 87480 |
|
104 |
95 |
$2K |
| 87510 |
|
104 |
95 |
$2K |
| 87660 |
|
104 |
95 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$2K |
| 81025 |
|
157 |
136 |
$725.83 |
| 0500F |
|
101 |
94 |
$0.00 |