| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,453 |
1,375 |
$49K |
| 97139 |
|
2,461 |
321 |
$39K |
| T1015 |
Clinic visit/encounter, all-inclusive |
277 |
202 |
$9K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
767 |
635 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
127 |
127 |
$5K |
| 81003 |
|
186 |
153 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
157 |
154 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
41 |
40 |
$1K |
| 97161 |
|
42 |
38 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
41 |
41 |
$1K |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
20 |
12 |
$446.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$421.67 |
| 0761 |
|
18 |
14 |
$380.32 |
| J3490 |
Unclassified drugs |
133 |
74 |
$267.14 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34 |
33 |
$97.20 |