| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
1,075 |
613 |
$44K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
224 |
197 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
580 |
401 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$875.64 |
| 87210 |
|
167 |
147 |
$691.18 |
| 76830 |
Ultrasound, transvaginal |
18 |
14 |
$515.28 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
18 |
14 |
$494.32 |
| 81025 |
|
159 |
129 |
$348.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
38 |
24 |
$317.50 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
82 |
76 |
$0.00 |