| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,636 |
1,704 |
$105K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
103 |
99 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
118 |
107 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
117 |
106 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
59 |
56 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
30 |
30 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
18 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
23 |
16 |
$1K |
| 87660 |
|
50 |
45 |
$922.30 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$914.70 |
| 87480 |
|
52 |
45 |
$802.00 |
| 87510 |
|
52 |
45 |
$802.00 |
| 81025 |
|
99 |
88 |
$596.86 |
| 80050 |
General health panel |
19 |
17 |
$559.30 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
70 |
65 |
$486.99 |
| 80061 |
Lipid panel |
19 |
17 |
$190.08 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12 |
12 |
$64.24 |