| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
307 |
155 |
$10K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
221 |
93 |
$9K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
190 |
125 |
$7K |
| 76820 |
|
202 |
91 |
$6K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
44 |
40 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
13 |
$976.74 |
| 81003 |
|
365 |
210 |
$304.05 |