| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99385 |
|
221 |
221 |
$38K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,316 |
1,170 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
300 |
294 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
475 |
442 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
174 |
174 |
$12K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
640 |
636 |
$12K |
| 90716 |
|
130 |
130 |
$10K |
| 90713 |
|
257 |
257 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
255 |
252 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
141 |
140 |
$7K |
| 99386 |
|
37 |
37 |
$6K |
| 90686 |
|
202 |
202 |
$3K |
| 86480 |
|
87 |
85 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
31 |
$3K |
| H0033 |
Oral medication administration, direct observation |
343 |
41 |
$3K |
| 87116 |
|
350 |
230 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
407 |
389 |
$2K |
| 80076 |
|
369 |
344 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
83 |
53 |
$2K |
| 99383 |
|
16 |
16 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
83 |
53 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
30 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
217 |
216 |
$2K |
| 99382 |
|
13 |
13 |
$2K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
79 |
59 |
$1K |
| 90480 |
|
30 |
30 |
$1K |
| 90746 |
|
15 |
15 |
$1K |
| 90707 |
|
14 |
14 |
$1K |
| 86803 |
|
63 |
63 |
$801.02 |
| 90633 |
|
81 |
81 |
$729.00 |
| 90715 |
|
27 |
27 |
$581.48 |
| 87556 |
|
22 |
16 |
$549.15 |
| 86706 |
|
46 |
46 |
$416.38 |
| 87340 |
|
47 |
47 |
$401.07 |
| 80053 |
Comprehensive metabolic panel |
41 |
40 |
$390.74 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
153 |
151 |
$373.48 |
| 86780 |
|
39 |
39 |
$306.01 |
| 0250 |
|
388 |
149 |
$282.82 |
| 86580 |
|
56 |
56 |
$170.86 |
| 90744 |
|
16 |
16 |
$144.00 |
| 91322 |
|
284 |
284 |
$139.00 |
| 86704 |
|
12 |
12 |
$134.18 |
| 82565 |
|
27 |
26 |
$110.35 |
| 90710 |
|
12 |
12 |
$99.00 |
| 86593 |
|
14 |
14 |
$40.06 |
| 36415 |
Collection of venous blood by venipuncture |
391 |
378 |
$35.50 |
| 3074F |
|
138 |
134 |
$0.00 |
| 1111F |
|
36 |
35 |
$0.00 |
| 3078F |
|
149 |
146 |
$0.00 |