| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 59426 |
|
220 |
179 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
441 |
370 |
$15K |
| 59410 |
|
15 |
14 |
$9K |
| 59425 |
|
136 |
116 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
92 |
92 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
79 |
78 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
29 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
37 |
37 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
45 |
41 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
55 |
53 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
57 |
42 |
$1K |
| 59025 |
Fetal non-stress test |
71 |
56 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
16 |
$1K |
| 76801 |
|
40 |
39 |
$944.44 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
79 |
79 |
$868.40 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
79 |
79 |
$868.40 |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$770.24 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
34 |
34 |
$568.62 |
| 81025 |
|
113 |
113 |
$364.65 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$325.53 |
| 87660 |
|
26 |
26 |
$218.41 |
| 87480 |
|
26 |
26 |
$218.41 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
52 |
52 |
$172.99 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
34 |
33 |
$131.94 |
| 36415 |
Collection of venous blood by venipuncture |
25 |
25 |
$88.10 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$75.38 |
| 81003 |
|
58 |
55 |
$58.87 |
| 87510 |
|
12 |
12 |
$36.10 |
| 81001 |
|
15 |
15 |
$28.50 |
| 81002 |
|
12 |
12 |
$25.04 |
| 81015 |
|
29 |
29 |
$22.00 |