| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
715 |
352 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
303 |
244 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
120 |
100 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
25 |
25 |
$2K |
| 76830 |
Ultrasound, transvaginal |
26 |
24 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
47 |
43 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
45 |
42 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$814.86 |
| 81025 |
|
100 |
94 |
$250.26 |
| 87210 |
|
27 |
26 |
$126.89 |
| 83986 |
|
27 |
26 |
$95.04 |
| 36415 |
Collection of venous blood by venipuncture |
29 |
28 |
$0.00 |