| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
235 |
177 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
117 |
90 |
$12K |
| 0502F |
|
70 |
64 |
$7K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
73 |
67 |
$6K |
| 86780 |
|
73 |
67 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
12 |
$595.40 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
12 |
$595.40 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
95 |
76 |
$528.08 |
| 86803 |
|
31 |
30 |
$510.36 |
| 87340 |
|
25 |
25 |
$337.50 |
| 81025 |
|
13 |
13 |
$67.21 |
| 82950 |
|
14 |
14 |
$65.24 |