| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,540 |
1,175 |
$149K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,404 |
503 |
$105K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
42 |
36 |
$56K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
821 |
757 |
$30K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
197 |
189 |
$24K |
| 76830 |
Ultrasound, transvaginal |
115 |
115 |
$13K |
| 59425 |
|
25 |
25 |
$12K |
| 59426 |
|
30 |
29 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
80 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
114 |
110 |
$3K |
| 81025 |
|
348 |
337 |
$2K |
| 90715 |
|
43 |
38 |
$925.01 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
43 |
38 |
$747.92 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
37 |
37 |
$452.46 |
| 0502F |
|
909 |
576 |
$0.00 |