| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,701 |
3,610 |
$12K |
| 76801 |
|
844 |
737 |
$10K |
| Z1034 |
|
145 |
93 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,144 |
7,401 |
$7K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
216 |
207 |
$5K |
| 99385 |
|
822 |
814 |
$2K |
| 81025 |
|
1,875 |
1,843 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
456 |
437 |
$1K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
5,727 |
5,692 |
$664.62 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
267 |
248 |
$615.50 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
698 |
695 |
$379.41 |
| 99386 |
|
2,074 |
2,063 |
$368.84 |
| 88150 |
|
346 |
341 |
$82.72 |
| 59025 |
Fetal non-stress test |
67 |
25 |
$24.63 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
30 |
$17.92 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
895 |
893 |
$0.00 |
| 99072 |
|
18 |
18 |
$0.00 |
| 87081 |
|
1,659 |
1,651 |
$0.00 |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
50 |
50 |
$0.00 |
| 87110 |
|
1,662 |
1,654 |
$0.00 |
| 59430 |
|
324 |
300 |
$0.00 |
| 87480 |
|
474 |
469 |
$0.00 |
| 58300 |
|
24 |
24 |
$0.00 |
| 58100 |
|
13 |
13 |
$0.00 |