| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,266 |
3,493 |
$338K |
| 59025 |
Fetal non-stress test |
3,645 |
2,645 |
$78K |
| 99220 |
|
125 |
95 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
230 |
204 |
$11K |
| 59410 |
|
15 |
13 |
$10K |
| 59020 |
|
460 |
336 |
$10K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
216 |
75 |
$2K |
| 76801 |
|
26 |
24 |
$2K |
| 76830 |
Ultrasound, transvaginal |
133 |
45 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
53 |
28 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
54 |
42 |
$481.93 |
| 90674 |
|
12 |
12 |
$264.59 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
526 |
303 |
$170.52 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
514 |
303 |
$170.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$164.83 |