| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 93975 |
|
5,269 |
5,239 |
$868K |
| 76830 |
Ultrasound, transvaginal |
5,336 |
5,319 |
$460K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
4,210 |
4,207 |
$302K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,170 |
4,155 |
$262K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,370 |
4,153 |
$252K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,526 |
1,508 |
$121K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
4,288 |
4,286 |
$95K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
388 |
386 |
$40K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
441 |
432 |
$37K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
2,176 |
2,174 |
$17K |
| 81025 |
|
3,021 |
2,884 |
$13K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
656 |
654 |
$12K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
656 |
654 |
$11K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
424 |
423 |
$10K |
| 87510 |
|
687 |
686 |
$7K |
| 87480 |
|
686 |
685 |
$7K |
| 87660 |
|
685 |
684 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
15 |
15 |
$2K |
| 86304 |
|
78 |
78 |
$773.40 |
| 86703 |
|
62 |
62 |
$456.01 |
| 86300 |
|
33 |
33 |
$434.88 |
| 82378 |
|
33 |
33 |
$404.24 |
| 84481 |
|
36 |
36 |
$384.96 |
| 86800 |
|
36 |
36 |
$381.28 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
19 |
19 |
$361.28 |
| 86376 |
|
36 |
36 |
$349.40 |
| 82105 |
|
33 |
33 |
$348.40 |
| 86803 |
|
37 |
37 |
$331.36 |
| 86708 |
|
37 |
37 |
$296.64 |
| 86704 |
|
37 |
37 |
$295.36 |
| 86738 |
|
32 |
32 |
$283.70 |
| 86706 |
|
37 |
37 |
$262.64 |
| 87340 |
|
37 |
37 |
$261.20 |
| 84443 |
Thyroid stimulating hormone (TSH) |
56 |
56 |
$256.92 |
| 86696 |
|
34 |
34 |
$248.61 |
| 86644 |
|
24 |
24 |
$232.36 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
37 |
37 |
$228.33 |
| 84439 |
|
36 |
36 |
$221.48 |
| 87625 |
|
514 |
513 |
$194.95 |
| 86695 |
|
34 |
34 |
$169.35 |
| 80061 |
Lipid panel |
19 |
19 |
$150.12 |
| 82977 |
|
31 |
31 |
$137.68 |
| 83735 |
|
31 |
31 |
$136.14 |
| 82550 |
|
31 |
31 |
$135.51 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37 |
37 |
$124.00 |
| 86645 |
|
24 |
24 |
$121.06 |
| 83525 |
|
13 |
13 |
$95.42 |
| 84550 |
|
31 |
31 |
$83.21 |
| 83001 |
|
52 |
52 |
$75.24 |
| 83002 |
|
32 |
32 |
$74.97 |
| 86301 |
|
33 |
33 |
$74.88 |
| 81002 |
|
40 |
40 |
$70.08 |
| 80053 |
Comprehensive metabolic panel |
21 |
19 |
$61.00 |
| 82671 |
|
39 |
39 |
$58.12 |
| 86593 |
|
34 |
34 |
$56.49 |
| 84100 |
|
31 |
31 |
$50.91 |
| 86337 |
|
19 |
19 |
$38.52 |
| 36415 |
Collection of venous blood by venipuncture |
109 |
109 |
$23.79 |
| 84703 |
|
33 |
33 |
$16.90 |
| 84436 |
|
48 |
48 |
$0.00 |
| 87623 |
|
133 |
132 |
$0.00 |
| 82533 |
|
15 |
15 |
$0.00 |
| 84480 |
|
48 |
48 |
$0.00 |
| 80051 |
|
19 |
19 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
19 |
19 |
$0.00 |
| 82627 |
|
15 |
15 |
$0.00 |
| 84146 |
|
35 |
35 |
$0.00 |
| 80076 |
|
19 |
19 |
$0.00 |