| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
115 |
106 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
79 |
78 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
79 |
78 |
$2K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
28 |
27 |
$2K |
| 87481 |
|
28 |
27 |
$947.43 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
28 |
27 |
$947.43 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
12 |
12 |
$651.29 |
| 86780 |
|
12 |
12 |
$160.20 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
12 |
$24.00 |
| 99000 |
|
12 |
12 |
$0.00 |