| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,042 |
3,689 |
$191K |
| 59426 |
|
149 |
149 |
$129K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,337 |
1,336 |
$108K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
28 |
28 |
$21K |
| 76830 |
Ultrasound, transvaginal |
217 |
217 |
$15K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
188 |
184 |
$12K |
| 59430 |
|
47 |
47 |
$10K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
278 |
278 |
$7K |
| 76801 |
|
76 |
75 |
$5K |
| 76820 |
|
153 |
150 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
14 |
$740.44 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
69 |
$584.88 |
| 90715 |
|
12 |
12 |
$354.97 |