| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
547 |
415 |
$39K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
198 |
159 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
413 |
251 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
183 |
118 |
$9K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
187 |
77 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
85 |
53 |
$6K |
| 76820 |
|
56 |
38 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
24 |
$2K |
| 81003 |
|
462 |
237 |
$1K |
| 90686 |
|
45 |
34 |
$803.83 |
| 90715 |
|
17 |
14 |
$582.76 |
| 99241 |
|
12 |
12 |
$431.09 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
12 |
$0.00 |