| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 93975 |
|
5,533 |
5,509 |
$1.08M |
| 76830 |
Ultrasound, transvaginal |
5,853 |
5,817 |
$492K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
4,320 |
4,314 |
$404K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,497 |
5,473 |
$323K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,590 |
4,335 |
$305K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
4,644 |
4,638 |
$148K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,001 |
991 |
$100K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
4,611 |
4,602 |
$77K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
288 |
287 |
$38K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
201 |
200 |
$18K |
| 81025 |
|
3,800 |
3,617 |
$14K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
664 |
661 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
664 |
661 |
$13K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
521 |
520 |
$12K |
| 87660 |
|
679 |
676 |
$8K |
| 87510 |
|
679 |
676 |
$8K |
| 87480 |
|
679 |
676 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
29 |
29 |
$3K |
| 87625 |
|
378 |
370 |
$754.88 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
14 |
13 |
$382.52 |
| 82627 |
|
12 |
12 |
$219.16 |
| 82533 |
|
13 |
13 |
$186.39 |
| 82677 |
|
13 |
13 |
$176.75 |
| 86703 |
|
13 |
13 |
$166.70 |
| 86376 |
|
13 |
13 |
$163.70 |
| 86696 |
|
13 |
13 |
$160.71 |
| 86800 |
|
13 |
13 |
$149.20 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$124.98 |
| 87340 |
|
12 |
12 |
$110.17 |
| 84481 |
|
13 |
13 |
$106.14 |
| 86803 |
|
12 |
12 |
$103.64 |
| 86704 |
|
12 |
12 |
$102.59 |
| 86708 |
|
12 |
12 |
$102.00 |
| 86706 |
|
12 |
12 |
$101.43 |
| 84439 |
|
13 |
13 |
$99.02 |
| 81002 |
|
42 |
41 |
$68.95 |
| 84270 |
|
13 |
13 |
$48.58 |
| 84480 |
|
13 |
13 |
$46.17 |
| 84436 |
|
13 |
13 |
$46.17 |
| 86593 |
|
13 |
13 |
$40.53 |
| 84703 |
|
13 |
13 |
$26.46 |
| 36415 |
Collection of venous blood by venipuncture |
32 |
26 |
$18.00 |
| 86695 |
|
16 |
13 |
$11.70 |
| 87623 |
|
93 |
92 |
$0.00 |