| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
100 |
100 |
$324.86 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
220 |
219 |
$188.64 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
118 |
115 |
$62.95 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
330 |
300 |
$51.84 |
| 76813 |
|
12 |
12 |
$0.00 |
| 76801 |
|
12 |
12 |
$0.00 |