| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,856 |
1,650 |
$101K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
339 |
296 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
66 |
63 |
$9K |
| 76801 |
|
57 |
56 |
$7K |
| 81025 |
|
1,114 |
996 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39 |
37 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
26 |
$3K |
| 99385 |
|
13 |
13 |
$2K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
13 |
$892.06 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
74 |
71 |
$683.10 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
25 |
25 |
$375.06 |
| 0503F |
|
93 |
78 |
$0.09 |
| 0500F |
|
156 |
147 |
$0.00 |
| 0501F |
|
27 |
24 |
$0.00 |
| 0502F |
|
2,648 |
1,926 |
$0.00 |