| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
924 |
641 |
$29K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
547 |
317 |
$19K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$17K |
| 81003 |
|
6,951 |
4,064 |
$6K |
| 59425 |
|
17 |
14 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
54 |
36 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
29 |
$110.00 |
| 90658 |
|
13 |
13 |
$86.40 |
| 0503F |
|
15 |
14 |
$0.00 |
| 0502F |
|
7,678 |
4,174 |
$0.00 |