| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
272 |
156 |
$26K |
| 59425 |
|
282 |
212 |
$26K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
105 |
94 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
284 |
247 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
117 |
111 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
71 |
65 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
46 |
$3K |
| 90715 |
|
49 |
47 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
13 |
$1K |
| 81025 |
|
200 |
154 |
$1K |
| 76801 |
|
15 |
12 |
$1K |
| 90756 |
|
30 |
30 |
$659.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
29 |
$433.16 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18 |
12 |
$208.62 |