| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
601 |
599 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
154 |
142 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
179 |
170 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
77 |
77 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
28 |
$4K |
| 81002 |
|
1,434 |
1,194 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
25 |
25 |
$3K |
| 87081 |
|
309 |
309 |
$2K |
| 88174 |
|
81 |
81 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
66 |
66 |
$1K |
| 81025 |
|
87 |
86 |
$645.53 |
| 90715 |
|
12 |
12 |
$427.68 |
| 36415 |
Collection of venous blood by venipuncture |
257 |
251 |
$425.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$236.66 |