| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
538 |
527 |
$15K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
526 |
515 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
172 |
163 |
$9K |
| 87481 |
|
136 |
132 |
$4K |
| 87511 |
|
135 |
132 |
$4K |
| 87660 |
|
139 |
136 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
33 |
33 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
30 |
$2K |
| 59025 |
Fetal non-stress test |
28 |
13 |
$1K |
| 76830 |
Ultrasound, transvaginal |
29 |
27 |
$709.52 |
| 81025 |
|
103 |
99 |
$665.04 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12 |
12 |
$374.04 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$355.55 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
13 |
$329.42 |
| 83986 |
|
20 |
20 |
$73.60 |