| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,867 |
1,791 |
$82K |
| 59426 |
|
66 |
64 |
$48K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
446 |
379 |
$28K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
299 |
299 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
101 |
101 |
$7K |
| 76830 |
Ultrasound, transvaginal |
65 |
65 |
$4K |
| 59430 |
|
24 |
24 |
$4K |
| 81025 |
|
507 |
501 |
$3K |
| 59025 |
Fetal non-stress test |
126 |
65 |
$3K |
| 76801 |
|
40 |
37 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
50 |
50 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
70 |
70 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$768.18 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$725.04 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
25 |
$345.44 |
| 81002 |
|
42 |
39 |
$116.87 |
| 0502F |
|
202 |
96 |
$0.00 |
| 99072 |
|
36 |
33 |
$0.00 |