| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,335 |
2,096 |
$125K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
153 |
130 |
$13K |
| 76830 |
Ultrasound, transvaginal |
122 |
118 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
72 |
68 |
$7K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
664 |
625 |
$6K |
| 81002 |
|
2,807 |
2,007 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
30 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
34 |
28 |
$2K |
| 99385 |
|
16 |
15 |
$2K |
| 99205 |
Prolong outpt/office vis |
15 |
12 |
$2K |
| 81025 |
|
427 |
390 |
$2K |
| A4550 |
Surgical trays |
30 |
29 |
$368.76 |
| 99000 |
|
1,355 |
1,208 |
$0.48 |