| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
158 |
136 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
72 |
68 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
25 |
$1K |
| 90674 |
|
29 |
26 |
$687.46 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
29 |
$333.20 |
| 81025 |
|
28 |
27 |
$204.36 |