| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,274 |
5,826 |
$482K |
| 99442 |
|
5,483 |
5,135 |
$415K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
3,289 |
3,288 |
$369K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,607 |
3,474 |
$357K |
| 76830 |
Ultrasound, transvaginal |
1,870 |
1,867 |
$201K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
1,163 |
1,162 |
$186K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
5,177 |
5,174 |
$173K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,701 |
1,698 |
$167K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,779 |
1,687 |
$84K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
598 |
598 |
$61K |
| 99441 |
|
1,136 |
1,085 |
$52K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
555 |
555 |
$46K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
303 |
303 |
$37K |
| 99401 |
|
788 |
750 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
260 |
260 |
$17K |
| 81025 |
|
2,555 |
2,401 |
$13K |
| 99443 |
|
120 |
118 |
$13K |
| 99386 |
|
203 |
203 |
$13K |
| 99385 |
|
154 |
154 |
$7K |
| 76857 |
|
134 |
126 |
$6K |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
146 |
146 |
$4K |
| 57456 |
|
25 |
25 |
$3K |
| 58340 |
|
12 |
12 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
2,037 |
1,957 |
$1K |
| 76831 |
|
12 |
12 |
$1K |
| 81002 |
|
374 |
372 |
$968.22 |
| 99051 |
|
261 |
249 |
$941.36 |
| 51784 |
|
14 |
12 |
$698.92 |
| 87077 |
|
71 |
71 |
$600.52 |
| 81000 |
|
102 |
102 |
$368.30 |
| 57500 |
|
26 |
26 |
$353.04 |
| 87073 |
|
66 |
65 |
$347.60 |
| S0612 |
Annual gynecological examination, established patient |
152 |
152 |
$60.00 |
| 36410 |
|
80 |
80 |
$59.12 |
| 81003 |
|
13 |
13 |
$31.27 |
| S0610 |
Annual gynecological examination, new patient |
14 |
14 |
$0.00 |
| 99000 |
|
595 |
567 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
33 |
33 |
$0.00 |