| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
323 |
301 |
$16K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
430 |
367 |
$14K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
432 |
265 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
138 |
131 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
29 |
29 |
$3K |
| 99442 |
|
78 |
63 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
52 |
43 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$1K |
| 76830 |
Ultrasound, transvaginal |
36 |
35 |
$807.49 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
33 |
33 |
$772.34 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
419 |
416 |
$82.50 |