| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
798 |
481 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
155 |
133 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
231 |
190 |
$11K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
125 |
83 |
$9K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
170 |
111 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
167 |
109 |
$8K |
| 0503F |
|
40 |
27 |
$4K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
55 |
46 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
77 |
57 |
$2K |
| 86780 |
|
125 |
83 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
19 |
13 |
$2K |
| 87481 |
|
25 |
14 |
$2K |
| 86803 |
|
68 |
43 |
$1K |
| 87511 |
|
23 |
14 |
$1K |
| 0500F |
|
19 |
15 |
$837.90 |
| 87340 |
|
58 |
43 |
$780.99 |
| 81025 |
|
133 |
109 |
$682.18 |
| 96127 |
|
28 |
20 |
$408.80 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
44 |
32 |
$251.98 |
| 86762 |
|
23 |
12 |
$197.63 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16 |
15 |
$100.49 |