| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81513 |
|
474 |
464 |
$52K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,499 |
1,484 |
$42K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,499 |
1,484 |
$42K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
550 |
550 |
$40K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
711 |
614 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
937 |
843 |
$24K |
| S4993 |
Contraceptive pills for birth control |
291 |
286 |
$23K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
474 |
464 |
$13K |
| 88142 |
|
541 |
539 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
602 |
590 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
171 |
159 |
$6K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
338 |
335 |
$6K |
| 76830 |
Ultrasound, transvaginal |
79 |
79 |
$6K |
| 84703 |
|
877 |
849 |
$5K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
182 |
182 |
$5K |
| 87800 |
|
141 |
140 |
$5K |
| 86780 |
|
342 |
337 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
219 |
185 |
$3K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
41 |
20 |
$2K |
| 90686 |
|
94 |
94 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
176 |
173 |
$2K |
| 90688 |
|
12 |
12 |
$201.60 |
| 87340 |
|
14 |
14 |
$125.32 |
| 81003 |
|
54 |
52 |
$90.72 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13 |
13 |
$54.24 |
| A4267 |
Contraceptive supply, condom, male, each |
40 |
39 |
$9.50 |
| 1160F |
|
361 |
335 |
$0.00 |
| 3078F |
|
251 |
238 |
$0.00 |
| 87481 |
|
368 |
358 |
$0.00 |
| 1000F |
|
369 |
341 |
$0.00 |
| 3008F |
|
363 |
338 |
$0.00 |
| 1036F |
|
163 |
152 |
$0.00 |
| 3074F |
|
279 |
265 |
$0.00 |
| 3079F |
|
31 |
30 |
$0.00 |
| 3044F |
|
46 |
43 |
$0.00 |