| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
892 |
755 |
$54K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
974 |
861 |
$43K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
673 |
575 |
$31K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
125 |
125 |
$13K |
| 59025 |
Fetal non-stress test |
343 |
171 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
161 |
161 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
51 |
47 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
20 |
15 |
$939.75 |
| 76801 |
|
12 |
12 |
$805.64 |
| 90686 |
|
15 |
15 |
$322.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
16 |
$261.25 |
| 81025 |
|
26 |
26 |
$187.76 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
14 |
$33.96 |
| 0500F |
|
12 |
12 |
$0.00 |
| 99024 |
|
40 |
40 |
$0.00 |