| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,724 |
2,229 |
$89K |
| 76830 |
Ultrasound, transvaginal |
294 |
290 |
$26K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
202 |
191 |
$19K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
573 |
565 |
$17K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
573 |
565 |
$17K |
| 99000 |
|
1,632 |
1,277 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
196 |
194 |
$14K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
149 |
125 |
$10K |
| 59430 |
|
109 |
98 |
$9K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
341 |
338 |
$8K |
| 59514 |
|
12 |
12 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
137 |
134 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
84 |
84 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
62 |
61 |
$5K |
| 80081 |
|
77 |
77 |
$5K |
| 59025 |
Fetal non-stress test |
129 |
80 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
97 |
95 |
$4K |
| 81025 |
|
673 |
662 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
398 |
319 |
$4K |
| 81002 |
|
1,400 |
1,031 |
$4K |
| 81001 |
|
1,399 |
1,367 |
$3K |
| CP002 |
|
343 |
245 |
$3K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
25 |
25 |
$930.12 |
| 90715 |
|
14 |
14 |
$710.00 |
| 88141 |
|
25 |
25 |
$617.21 |
| 87186 |
|
66 |
65 |
$537.88 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
27 |
27 |
$524.57 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
67 |
66 |
$506.26 |
| 82947 |
|
89 |
89 |
$318.54 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37 |
35 |
$260.70 |
| 84702 |
|
14 |
12 |
$164.25 |
| 82950 |
|
35 |
32 |
$146.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$120.68 |
| 86592 |
|
15 |
15 |
$55.86 |
| 99080 |
|
17 |
16 |
$0.00 |