| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,545 |
2,285 |
$198K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
630 |
576 |
$60K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
545 |
544 |
$53K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
1,130 |
1,126 |
$40K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
397 |
397 |
$39K |
| 59025 |
Fetal non-stress test |
93 |
38 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
40 |
40 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$552.90 |