| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
348 |
334 |
$20K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
72 |
72 |
$7K |
| 76830 |
Ultrasound, transvaginal |
120 |
119 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
86 |
51 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
70 |
56 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
15 |
15 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
32 |
32 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
48 |
$1K |
| 90686 |
|
31 |
31 |
$576.94 |