| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
443 |
397 |
$26K |
| 99205 |
Prolong outpt/office vis |
29 |
29 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
39 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
114 |
109 |
$937.54 |
| 81002 |
|
501 |
389 |
$931.72 |
| 81025 |
|
127 |
116 |
$715.11 |
| A4550 |
Surgical trays |
13 |
12 |
$307.30 |
| 99000 |
|
300 |
284 |
$0.00 |