| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
204 |
194 |
$3K |
| 87116 |
|
138 |
105 |
$986.29 |
| 80076 |
|
193 |
165 |
$812.85 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
83 |
74 |
$363.26 |
| 86780 |
|
13 |
13 |
$260.16 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
14 |
14 |
$221.06 |
| 87535 |
|
12 |
12 |
$201.65 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
12 |
$190.32 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$116.52 |
| 86702 |
|
13 |
13 |
$81.95 |
| 86593 |
|
14 |
14 |
$63.59 |
| 86701 |
|
13 |
13 |
$54.82 |
| 71045 |
Radiologic examination, chest; single view |
12 |
12 |
$48.20 |
| 86592 |
|
12 |
12 |
$34.68 |
| 36415 |
Collection of venous blood by venipuncture |
386 |
331 |
$31.96 |
| 0510 |
|
17 |
16 |
$0.00 |