| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,115 |
4,660 |
$159K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
842 |
821 |
$123K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
827 |
804 |
$89K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
848 |
825 |
$65K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
359 |
306 |
$50K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
474 |
437 |
$50K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
213 |
200 |
$46K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,189 |
1,146 |
$43K |
| 86780 |
|
850 |
826 |
$42K |
| 76801 |
|
231 |
225 |
$31K |
| 86803 |
|
267 |
259 |
$25K |
| 86481 |
|
136 |
132 |
$23K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
334 |
315 |
$23K |
| 86850 |
|
445 |
438 |
$23K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
88 |
88 |
$21K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
287 |
279 |
$21K |
| 87340 |
|
316 |
310 |
$20K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
132 |
126 |
$16K |
| 86762 |
|
171 |
166 |
$15K |
| 86901 |
|
434 |
426 |
$15K |
| 86900 |
|
434 |
426 |
$15K |
| 82728 |
|
149 |
145 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
271 |
268 |
$10K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
139 |
135 |
$6K |
| 86787 |
|
64 |
61 |
$6K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
61 |
59 |
$6K |
| 81025 |
|
121 |
119 |
$5K |
| 81001 |
|
121 |
120 |
$4K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
59 |
56 |
$2K |
| 87150 |
|
13 |
12 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
24 |
24 |
$1K |
| 82950 |
|
43 |
43 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
12 |
$693.05 |
| 87088 |
|
14 |
13 |
$437.64 |
| 87210 |
|
14 |
14 |
$239.96 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
14 |
14 |
$147.00 |
| 3078F |
|
642 |
558 |
$6.40 |
| 1036F |
|
82 |
80 |
$0.82 |
| 3074F |
|
29 |
25 |
$0.29 |