| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
909 |
800 |
$38K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
313 |
290 |
$32K |
| 76830 |
Ultrasound, transvaginal |
337 |
292 |
$24K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
154 |
142 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
131 |
118 |
$8K |
| 81025 |
|
931 |
854 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
27 |
26 |
$2K |
| 81002 |
|
666 |
609 |
$2K |
| 90686 |
|
77 |
75 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
136 |
126 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$965.82 |
| 90715 |
|
15 |
13 |
$562.45 |
| 81003 |
|
21 |
17 |
$42.51 |
| 0503F |
|
78 |
72 |
$0.08 |
| 0502F |
|
67 |
52 |
$0.00 |