| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
186 |
186 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
261 |
258 |
$18K |
| 76801 |
|
131 |
131 |
$13K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$8K |
| 76830 |
Ultrasound, transvaginal |
52 |
52 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
62 |
59 |
$994.07 |
| 90715 |
|
12 |
12 |
$384.60 |
| 90686 |
|
15 |
15 |
$254.55 |
| 96127 |
|
26 |
26 |
$105.72 |