| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,122 |
1,086 |
$167K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,119 |
1,083 |
$117K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,238 |
2,091 |
$98K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
982 |
949 |
$75K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
844 |
794 |
$59K |
| 86780 |
|
963 |
931 |
$52K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,149 |
1,094 |
$49K |
| 86481 |
|
216 |
200 |
$32K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
275 |
263 |
$29K |
| 86803 |
|
213 |
199 |
$28K |
| 86787 |
|
221 |
204 |
$25K |
| 86850 |
|
303 |
285 |
$25K |
| 86762 |
|
223 |
206 |
$25K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
803 |
720 |
$25K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
432 |
421 |
$24K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
81 |
81 |
$22K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
206 |
191 |
$22K |
| 87340 |
|
221 |
205 |
$21K |
| 86900 |
|
303 |
285 |
$20K |
| 86901 |
|
303 |
285 |
$20K |
| 59426 |
|
28 |
28 |
$19K |
| 87150 |
|
140 |
137 |
$14K |
| 81001 |
|
185 |
171 |
$14K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
118 |
95 |
$10K |
| 59430 |
|
84 |
84 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
132 |
132 |
$8K |
| 76830 |
Ultrasound, transvaginal |
27 |
27 |
$8K |
| 83020 |
|
43 |
40 |
$8K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
28 |
28 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
544 |
523 |
$8K |
| 81025 |
|
1,587 |
1,547 |
$8K |
| 82950 |
|
197 |
191 |
$6K |
| 83021 |
|
43 |
40 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
656 |
630 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
74 |
70 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
66 |
65 |
$4K |
| S0612 |
Annual gynecological examination, established patient |
61 |
60 |
$4K |
| 82105 |
|
63 |
59 |
$3K |
| 87210 |
|
701 |
677 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$738.90 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$375.46 |