| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
728 |
675 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
143 |
131 |
$11K |
| 87800 |
|
73 |
72 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
137 |
137 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$1K |
| 59025 |
Fetal non-stress test |
30 |
14 |
$945.60 |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$838.75 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
13 |
$829.05 |
| 99459 |
|
58 |
57 |
$825.36 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
482 |
478 |
$0.00 |