| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
80 |
79 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
128 |
109 |
$9K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
152 |
112 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
53 |
53 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
95 |
81 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
52 |
42 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
14 |
$617.43 |