| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,292 |
1,133 |
$61K |
| 76830 |
Ultrasound, transvaginal |
229 |
198 |
$28K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
633 |
619 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
140 |
140 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
101 |
95 |
$8K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
43 |
42 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
25 |
25 |
$3K |
| 76857 |
|
13 |
13 |
$669.60 |
| A4402 |
Lubricant, per ounce |
49 |
49 |
$51.45 |