| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1001 |
Nursing assessment / evaluation |
3,463 |
2,993 |
$137K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
331 |
330 |
$6K |
| 96127 |
|
1,028 |
1,028 |
$4K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
81 |
77 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
360 |
351 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
152 |
152 |
$2K |
| 91322 |
|
21 |
21 |
$2K |
| 81025 |
|
196 |
194 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$1K |
| 90656 |
|
167 |
166 |
$960.46 |
| 90480 |
|
21 |
21 |
$840.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$374.52 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$374.52 |
| 92588 |
|
12 |
12 |
$363.96 |
| 99406 |
|
28 |
28 |
$359.72 |
| 92550 |
|
15 |
15 |
$296.85 |
| 92587 |
|
13 |
13 |
$245.83 |
| 36416 |
|
89 |
89 |
$232.29 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$191.36 |
| 99188 |
|
14 |
14 |
$145.18 |
| A4267 |
Contraceptive supply, condom, male, each |
66 |
66 |
$66.50 |
| 90661 |
|
19 |
19 |
$0.00 |