| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,156 |
973 |
$103K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
438 |
422 |
$67K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
174 |
174 |
$20K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,022 |
1,004 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
76 |
76 |
$5K |
| 76830 |
Ultrasound, transvaginal |
40 |
38 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
40 |
38 |
$4K |
| 81025 |
|
173 |
148 |
$689.16 |
| 99070 |
|
41 |
41 |
$105.00 |
| 99000 |
|
2,074 |
1,950 |
$0.00 |