| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,327 |
3,917 |
$459K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
491 |
406 |
$38K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
305 |
283 |
$9K |
| 81003 |
|
4,309 |
2,374 |
$9K |
| 76801 |
|
104 |
69 |
$7K |
| 36410 |
|
586 |
415 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
49 |
40 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
38 |
27 |
$3K |
| 76857 |
|
25 |
25 |
$2K |
| 81025 |
|
376 |
279 |
$1K |
| 81002 |
|
419 |
254 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$934.70 |
| H1000 |
Prenatal care, at-risk assessment |
59 |
52 |
$863.59 |