| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
336 |
335 |
$48K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
323 |
322 |
$35K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
119 |
118 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
71 |
69 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
83 |
74 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
122 |
120 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
24 |
24 |
$1K |
| 76830 |
Ultrasound, transvaginal |
14 |
13 |
$903.84 |
| 81025 |
|
105 |
101 |
$482.34 |
| 81001 |
|
13 |
12 |
$173.52 |
| 87210 |
|
14 |
13 |
$40.57 |