| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,389 |
1,100 |
$200K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,650 |
1,958 |
$158K |
| 76830 |
Ultrasound, transvaginal |
1,619 |
1,291 |
$142K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,420 |
1,201 |
$112K |
| 93976 |
|
1,444 |
1,210 |
$91K |
| 76818 |
|
972 |
373 |
$88K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,756 |
1,274 |
$82K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,529 |
1,115 |
$76K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
886 |
470 |
$58K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
261 |
189 |
$20K |
| 57511 |
|
71 |
57 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
133 |
79 |
$7K |
| 99223 |
Prolong inpt eval add15 m |
52 |
39 |
$2K |
| 59025 |
Fetal non-stress test |
117 |
50 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
20 |
16 |
$2K |
| 76820 |
|
69 |
25 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
16 |
15 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
20 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
34 |
12 |
$1K |