| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
923 |
777 |
$52K |
| 76830 |
Ultrasound, transvaginal |
490 |
487 |
$45K |
| 58558 |
|
15 |
15 |
$16K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
562 |
562 |
$13K |
| 57150 |
|
159 |
157 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
62 |
62 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$2K |
| 58340 |
|
13 |
13 |
$2K |
| 81025 |
|
467 |
416 |
$1K |
| 99459 |
|
66 |
65 |
$1K |
| 99385 |
|
12 |
12 |
$1K |
| 76831 |
|
12 |
12 |
$1K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
580 |
578 |
$117.09 |
| 81002 |
|
62 |
61 |
$102.41 |
| 36415 |
Collection of venous blood by venipuncture |
41 |
36 |
$1.35 |