| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
635 |
567 |
$38K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
753 |
648 |
$32K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
748 |
649 |
$31K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
28 |
28 |
$26K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
383 |
337 |
$17K |
| 0502F |
|
135 |
106 |
$12K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
423 |
342 |
$12K |
| 86780 |
|
637 |
568 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
111 |
85 |
$9K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
134 |
115 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
87 |
78 |
$5K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
110 |
91 |
$5K |
| 86803 |
|
265 |
231 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
638 |
570 |
$4K |
| 87340 |
|
244 |
217 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
16 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
51 |
45 |
$2K |
| 86762 |
|
223 |
196 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
32 |
25 |
$2K |
| 82950 |
|
156 |
144 |
$718.76 |