| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
128 |
94 |
$14K |
| 99051 |
|
867 |
652 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
103 |
81 |
$5K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
33 |
33 |
$3K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
67 |
65 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
204 |
147 |
$2K |
| 90461 |
|
279 |
275 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
421 |
411 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
12 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
54 |
37 |
$823.75 |
| 90677 |
|
56 |
52 |
$643.88 |
| 90633 |
|
131 |
107 |
$148.69 |
| 90670 |
|
23 |
12 |
$84.00 |
| 90734 |
|
138 |
120 |
$72.93 |
| 90651 |
|
146 |
138 |
$1.07 |
| 90715 |
|
70 |
65 |
$0.54 |
| 90621 |
|
55 |
53 |
$0.46 |
| 90707 |
|
50 |
48 |
$0.46 |
| 90716 |
|
49 |
47 |
$0.43 |
| 90697 |
|
21 |
20 |
$0.18 |
| 90700 |
|
18 |
18 |
$0.17 |
| 90696 |
|
15 |
15 |
$0.14 |
| 90698 |
|
17 |
15 |
$0.13 |
| 90647 |
|
13 |
13 |
$0.12 |
| 90832 |
Psychotherapy, 30 minutes with patient |
258 |
220 |
$0.00 |
| 90671 |
|
17 |
17 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
16 |
16 |
$0.00 |