| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,665 |
1,665 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,414 |
3,206 |
$4K |
| 88150 |
|
2,852 |
2,848 |
$1K |
| 99385 |
|
369 |
369 |
$684.00 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
41 |
38 |
$628.36 |
| 99386 |
|
558 |
558 |
$615.60 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
257 |
257 |
$450.00 |
| 59425 |
|
289 |
164 |
$371.84 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
145 |
144 |
$345.18 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
401 |
397 |
$245.02 |
| 87660 |
|
175 |
172 |
$174.73 |
| 87802 |
|
13 |
13 |
$40.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
38 |
38 |
$37.50 |
| 58100 |
|
74 |
74 |
$32.83 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
51 |
51 |
$25.11 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
62 |
59 |
$17.92 |
| 87110 |
|
358 |
357 |
$17.12 |
| 87081 |
|
363 |
362 |
$5.62 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
884 |
883 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
14 |
14 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
54 |
54 |
$0.00 |
| 81025 |
|
258 |
257 |
$0.00 |
| 99442 |
|
14 |
12 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
19 |
14 |
$0.00 |