| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
159 |
123 |
$16K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
256 |
120 |
$9K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
120 |
117 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
120 |
117 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
120 |
117 |
$4K |
| 87511 |
|
116 |
113 |
$4K |
| 87581 |
|
109 |
108 |
$4K |
| 87480 |
|
240 |
102 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34 |
33 |
$3K |
| 87481 |
|
23 |
16 |
$1K |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
14 |
$1K |
| 81000 |
|
78 |
55 |
$230.40 |
| 81025 |
|
32 |
32 |
$191.52 |
| 99000 |
|
106 |
102 |
$0.00 |