| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
479 |
453 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,634 |
1,537 |
$27K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
129 |
117 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
56 |
51 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
54 |
53 |
$4K |
| 76830 |
Ultrasound, transvaginal |
39 |
37 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
27 |
25 |
$2K |
| 81025 |
|
342 |
312 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
21 |
13 |
$2K |
| 76801 |
|
12 |
12 |
$1K |
| 81002 |
|
123 |
114 |
$347.39 |
| 0501F |
|
12 |
12 |
$0.00 |
| 3016F |
|
13 |
12 |
$0.00 |