| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
768 |
676 |
$52.92 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
745 |
745 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
424 |
424 |
$0.00 |
| 59425 |
|
1,077 |
620 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
27 |
27 |
$0.00 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
86 |
86 |
$0.00 |
| 99429 |
|
40 |
40 |
$0.00 |
| 87625 |
|
15 |
15 |
$0.00 |