| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,327 |
10,044 |
$760K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,997 |
4,007 |
$419K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
1,145 |
1,075 |
$39K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
132 |
126 |
$24K |
| 59025 |
Fetal non-stress test |
733 |
300 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
758 |
656 |
$21K |
| 81025 |
|
1,898 |
1,730 |
$14K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
175 |
156 |
$13K |
| 76830 |
Ultrasound, transvaginal |
164 |
160 |
$12K |
| 99401 |
|
381 |
357 |
$9K |
| 99215 |
Prolong outpt/office vis |
61 |
58 |
$8K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
402 |
372 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
102 |
97 |
$5K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
625 |
582 |
$3K |
| 58120 |
|
12 |
12 |
$2K |
| 80305 |
|
95 |
87 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
16 |
$794.75 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
47 |
24 |
$635.98 |
| 81002 |
|
229 |
171 |
$615.25 |
| 99408 |
|
329 |
299 |
$248.58 |
| S9999 |
Sales tax |
2,948 |
1,650 |
$5.41 |
| 3074F |
|
82 |
65 |
$0.06 |
| 3077F |
|
66 |
58 |
$0.04 |
| 3078F |
|
58 |
47 |
$0.03 |
| 3080F |
|
68 |
58 |
$0.03 |
| 3075F |
|
13 |
13 |
$0.01 |
| 0502F |
|
378 |
235 |
$0.00 |
| 3079F |
|
16 |
15 |
$0.00 |