| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87660 |
|
903 |
879 |
$14K |
| 87480 |
|
904 |
880 |
$7K |
| 87510 |
|
902 |
878 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
207 |
204 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
206 |
204 |
$6K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
43 |
39 |
$2K |
| 76820 |
|
32 |
24 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
166 |
153 |
$727.32 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
13 |
$367.56 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$321.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
14 |
$141.76 |
| 3078F |
|
406 |
393 |
$0.00 |
| 3074F |
|
414 |
404 |
$0.00 |