| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,702 |
7,198 |
$354K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,834 |
2,831 |
$228K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,217 |
1,210 |
$111K |
| 59426 |
|
130 |
130 |
$108K |
| 76830 |
Ultrasound, transvaginal |
1,559 |
1,547 |
$105K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,565 |
1,556 |
$79K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
3,246 |
3,236 |
$71K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,011 |
1,011 |
$67K |
| 81025 |
|
9,457 |
8,760 |
$64K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,206 |
761 |
$58K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
735 |
676 |
$46K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
554 |
550 |
$43K |
| 76801 |
|
599 |
579 |
$41K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
375 |
375 |
$33K |
| 81003 |
|
17,816 |
13,374 |
$32K |
| 76820 |
|
1,237 |
780 |
$32K |
| 99385 |
|
315 |
314 |
$31K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
574 |
538 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
654 |
636 |
$19K |
| 85018 |
|
6,954 |
6,919 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,389 |
1,361 |
$12K |
| 59430 |
|
50 |
50 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$10K |
| 96127 |
|
3,382 |
3,370 |
$9K |
| 59025 |
Fetal non-stress test |
345 |
109 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
95 |
53 |
$4K |
| 99408 |
|
161 |
160 |
$3K |
| 99406 |
|
307 |
301 |
$2K |
| 54150 |
|
38 |
38 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
30 |
30 |
$2K |
| 57465 |
|
28 |
28 |
$856.19 |
| 81002 |
|
79 |
72 |
$175.33 |
| 99459 |
|
15 |
15 |
$159.28 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$150.37 |
| 96160 |
|
13 |
13 |
$61.06 |
| 0500F |
|
661 |
562 |
$0.00 |
| 0503F |
|
494 |
404 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
107 |
107 |
$0.00 |
| 3725F |
|
388 |
384 |
$0.00 |
| 0502F |
|
10,467 |
4,879 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,769 |
1,760 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
14 |
14 |
$0.00 |