| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,373 |
4,446 |
$163K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,041 |
2,726 |
$135K |
| 99000 |
|
1,807 |
1,624 |
$19K |
| 81002 |
|
4,793 |
3,425 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
96 |
96 |
$10K |
| 59514 |
|
12 |
12 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
110 |
94 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
80 |
79 |
$7K |
| 76830 |
Ultrasound, transvaginal |
75 |
69 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
262 |
234 |
$6K |
| 81025 |
|
644 |
625 |
$4K |
| 99215 |
Prolong outpt/office vis |
50 |
50 |
$3K |
| 76813 |
|
29 |
27 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
248 |
244 |
$2K |
| 90756 |
|
89 |
88 |
$2K |
| 90674 |
|
30 |
30 |
$706.26 |
| 90715 |
|
14 |
14 |
$488.19 |
| 90661 |
|
16 |
16 |
$388.89 |
| 96127 |
|
2,077 |
2,033 |
$189.70 |
| 0500F |
|
96 |
96 |
$0.00 |
| 0503F |
|
28 |
28 |
$0.00 |
| 0502F |
|
4,331 |
3,032 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
58 |
58 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
47 |
47 |
$0.00 |