| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
606 |
529 |
$31K |
| 59426 |
|
384 |
232 |
$25K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
175 |
156 |
$10K |
| 59425 |
|
128 |
102 |
$7K |
| 81025 |
|
657 |
543 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
160 |
129 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
161 |
129 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
60 |
48 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
13 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$1K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
35 |
26 |
$507.00 |
| 85014 |
|
92 |
78 |
$107.07 |
| 81001 |
|
40 |
28 |
$77.66 |
| 85018 |
|
13 |
13 |
$26.40 |