| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
292 |
194 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
118 |
84 |
$4K |
| 81003 |
|
623 |
373 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
12 |
$889.08 |