| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 58558 |
|
1,782 |
1,171 |
$553K |
| 99215 |
Prolong outpt/office vis |
2,332 |
1,588 |
$145K |
| 76830 |
Ultrasound, transvaginal |
3,056 |
2,164 |
$141K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,809 |
1,991 |
$124K |
| 99205 |
Prolong outpt/office vis |
1,732 |
1,137 |
$118K |
| 57425 |
|
199 |
98 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,416 |
1,136 |
$67K |
| 58662 |
|
274 |
132 |
$59K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
360 |
317 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
643 |
532 |
$21K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,302 |
912 |
$18K |
| 52000 |
|
221 |
203 |
$17K |
| 52005 |
|
57 |
52 |
$7K |
| 58661 |
|
23 |
12 |
$6K |
| 57452 |
|
142 |
109 |
$4K |
| 81025 |
|
792 |
611 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
36 |
$2K |
| 58100 |
|
55 |
29 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
18 |
14 |
$887.41 |
| 81003 |
|
402 |
335 |
$428.51 |
| 81002 |
|
197 |
170 |
$350.88 |