| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
763 |
569 |
$76K |
| 0502F |
|
485 |
332 |
$44K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
196 |
129 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
244 |
217 |
$18K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
114 |
96 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
57 |
50 |
$5K |
| 76830 |
Ultrasound, transvaginal |
63 |
57 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
35 |
30 |
$3K |
| 86780 |
|
114 |
96 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
141 |
117 |
$803.83 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
17 |
12 |
$596.53 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
17 |
12 |
$596.53 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
17 |
12 |
$488.24 |
| 99459 |
|
14 |
14 |
$204.68 |
| 82950 |
|
14 |
13 |
$62.39 |