| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,154 |
7,331 |
$271K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
359 |
333 |
$25K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
806 |
776 |
$21K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
189 |
188 |
$17K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
14 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
253 |
127 |
$0.00 |
| A4550 |
Surgical trays |
32 |
24 |
$0.00 |
| 99072 |
|
1,170 |
901 |
$0.00 |