| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,608 |
4,137 |
$173K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
791 |
679 |
$51K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
148 |
146 |
$15K |
| 81025 |
|
1,459 |
1,295 |
$8K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
163 |
156 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
30 |
26 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
105 |
91 |
$2K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$1K |
| 90686 |
|
60 |
38 |
$1K |
| 76857 |
|
12 |
12 |
$586.58 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19 |
12 |
$263.16 |
| 81002 |
|
84 |
78 |
$170.18 |