| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,991 |
1,915 |
$66K |
| T1015 |
Clinic visit/encounter, all-inclusive |
525 |
395 |
$34K |
| 97139 |
|
1,354 |
190 |
$19K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
373 |
370 |
$18K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
6,072 |
4,346 |
$15K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
57 |
57 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
393 |
375 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
955 |
838 |
$1K |
| 0450 |
Emergency room services |
27 |
26 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
81 |
79 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$741.94 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
27 |
27 |
$727.08 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
38 |
38 |
$723.18 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$535.31 |
| 0760 |
|
20 |
13 |
$404.12 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
237 |
233 |
$36.67 |
| 81003 |
|
308 |
220 |
$6.28 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
124 |
123 |
$5.35 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
84 |
$0.00 |
| 81025 |
|
16 |
16 |
$0.00 |