| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,436 |
4,199 |
$206K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,883 |
1,883 |
$153K |
| 76830 |
Ultrasound, transvaginal |
1,388 |
1,374 |
$99K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
992 |
992 |
$91K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
3,649 |
3,631 |
$51K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
678 |
673 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
516 |
496 |
$34K |
| 59426 |
|
26 |
26 |
$25K |
| 81025 |
|
2,656 |
2,602 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
558 |
545 |
$15K |
| 99385 |
|
126 |
126 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
171 |
171 |
$10K |
| 99459 |
|
444 |
440 |
$6K |
| 76801 |
|
37 |
37 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
134 |
132 |
$1K |
| 57454 |
|
12 |
12 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 59025 |
Fetal non-stress test |
33 |
13 |
$949.44 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
12 |
$731.65 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
14 |
$608.30 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$86.10 |
| 81002 |
|
25 |
25 |
$33.32 |
| 3725F |
|
1,234 |
1,234 |
$0.00 |
| 3078F |
|
1,980 |
1,910 |
$0.00 |
| 1159F |
|
1,907 |
1,838 |
$0.00 |
| 1160F |
|
1,881 |
1,814 |
$0.00 |
| 3077F |
|
138 |
136 |
$0.00 |
| 3008F |
|
5,179 |
5,096 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,870 |
1,866 |
$0.00 |
| 1034F |
|
333 |
319 |
$0.00 |
| 1036F |
|
4,201 |
4,137 |
$0.00 |
| 3075F |
|
249 |
241 |
$0.00 |
| 3079F |
|
1,092 |
1,076 |
$0.00 |
| 3074F |
|
2,581 |
2,479 |
$0.00 |
| 1035F |
|
15 |
15 |
$0.00 |
| 3080F |
|
25 |
25 |
$0.00 |