| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59025 |
Fetal non-stress test |
162 |
101 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
79 |
77 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
140 |
134 |
$1K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
15 |
15 |
$905.08 |
| 76818 |
|
16 |
13 |
$440.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
38 |
36 |
$345.60 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
14 |
$327.60 |