| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,435 |
3,083 |
$164K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
581 |
581 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
677 |
629 |
$45K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,942 |
1,910 |
$40K |
| 76830 |
Ultrasound, transvaginal |
285 |
282 |
$20K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
289 |
284 |
$18K |
| 99205 |
Prolong outpt/office vis |
130 |
130 |
$16K |
| 81002 |
|
4,423 |
3,765 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
67 |
52 |
$3K |
| 99215 |
Prolong outpt/office vis |
28 |
26 |
$2K |
| 57454 |
|
12 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$162.78 |
| 82274 |
|
13 |
13 |
$144.98 |
| 87210 |
|
28 |
28 |
$115.84 |