| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,690 |
1,689 |
$194K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,365 |
2,232 |
$181K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,890 |
4,857 |
$106K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
4,894 |
4,861 |
$106K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,884 |
4,851 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
525 |
507 |
$62K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
371 |
363 |
$31K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
223 |
223 |
$18K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
12 |
12 |
$11K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
287 |
287 |
$10K |
| 87480 |
|
640 |
630 |
$9K |
| 87510 |
|
638 |
628 |
$9K |
| 87660 |
|
634 |
624 |
$9K |
| 99459 |
|
317 |
309 |
$7K |
| 84703 |
|
2,885 |
2,813 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
446 |
432 |
$6K |
| 59840 |
|
26 |
26 |
$6K |
| 99401 |
|
149 |
147 |
$4K |
| 76857 |
|
66 |
62 |
$4K |
| 76830 |
Ultrasound, transvaginal |
45 |
45 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
186 |
174 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
41 |
41 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$2K |
| 99385 |
|
12 |
12 |
$2K |
| 81003 |
|
799 |
766 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
13 |
$1K |
| 90686 |
|
57 |
57 |
$1K |
| 58300 |
|
12 |
12 |
$723.81 |
| 85018 |
|
260 |
260 |
$522.08 |
| 86901 |
|
13 |
13 |
$47.97 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
107 |
106 |
$15.19 |