| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,470 |
1,309 |
$101K |
| 76830 |
Ultrasound, transvaginal |
628 |
626 |
$69K |
| 99442 |
|
885 |
856 |
$60K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
581 |
522 |
$60K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
550 |
548 |
$55K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
380 |
380 |
$11K |
| 99401 |
|
531 |
428 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
100 |
100 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
110 |
103 |
$6K |
| 99386 |
|
51 |
51 |
$6K |
| 58340 |
|
13 |
13 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
32 |
27 |
$2K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
13 |
13 |
$2K |
| 76831 |
|
13 |
13 |
$1K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
118 |
118 |
$973.05 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$875.09 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
59 |
59 |
$863.37 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
56 |
56 |
$245.21 |
| 3074F |
|
1,682 |
1,422 |
$245.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
30 |
25 |
$229.94 |
| 81025 |
|
44 |
43 |
$221.62 |
| 3078F |
|
1,421 |
1,202 |
$210.00 |
| 1126F |
|
772 |
686 |
$147.00 |
| 81000 |
|
18 |
13 |
$54.68 |
| 36415 |
Collection of venous blood by venipuncture |
30 |
28 |
$46.25 |
| 81002 |
|
13 |
13 |
$31.18 |
| 1159F |
|
730 |
631 |
$28.00 |
| 2010F |
|
2,483 |
2,105 |
$0.00 |
| 2001F |
|
2,466 |
2,088 |
$0.00 |
| 3008F |
|
2,468 |
2,090 |
$0.00 |
| 2000F |
|
1,690 |
1,490 |
$0.00 |
| 3079F |
|
15 |
12 |
$0.00 |
| 1036F |
|
13 |
12 |
$0.00 |
| 1160F |
|
475 |
406 |
$0.00 |
| 3725F |
|
14 |
14 |
$0.00 |