| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81513 |
|
395 |
390 |
$40K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,302 |
1,291 |
$31K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,302 |
1,291 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,089 |
1,062 |
$30K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
338 |
338 |
$25K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
346 |
344 |
$23K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
395 |
390 |
$10K |
| 88142 |
|
595 |
594 |
$8K |
| 84703 |
|
1,315 |
1,267 |
$7K |
| 87800 |
|
214 |
212 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
149 |
146 |
$6K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
196 |
195 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
385 |
383 |
$5K |
| 76830 |
Ultrasound, transvaginal |
43 |
42 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
156 |
156 |
$3K |
| 86780 |
|
155 |
154 |
$2K |
| 99385 |
|
22 |
22 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
68 |
66 |
$803.88 |
| 90686 |
|
28 |
28 |
$396.66 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
30 |
$342.98 |
| 80074 |
|
25 |
25 |
$193.12 |
| 81003 |
|
56 |
53 |
$99.39 |
| 87481 |
|
283 |
279 |
$0.00 |