| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
723 |
608 |
$24K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
162 |
148 |
$11K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
103 |
72 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
49 |
37 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
46 |
39 |
$3K |
| 81025 |
|
348 |
303 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
26 |
24 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
21 |
12 |
$1K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$926.39 |
| 87210 |
|
217 |
177 |
$584.52 |
| 0500F |
|
40 |
37 |
$250.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$199.11 |
| 81002 |
|
38 |
36 |
$77.68 |
| 0502F |
|
14 |
14 |
$10.00 |