| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,167 |
3,982 |
$267K |
| 76830 |
Ultrasound, transvaginal |
1,806 |
1,738 |
$159K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
296 |
292 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
197 |
197 |
$15K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
138 |
137 |
$11K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
231 |
230 |
$3K |
| 81005 |
|
2,321 |
2,002 |
$3K |
| 99401 |
|
133 |
133 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22 |
22 |
$1K |
| 88174 |
|
100 |
100 |
$1K |
| 81002 |
|
681 |
593 |
$1K |
| 76857 |
|
13 |
12 |
$436.43 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
441 |
439 |
$367.38 |
| 81025 |
|
12 |
12 |
$51.72 |
| 0502F |
|
133 |
85 |
$0.00 |