| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,640 |
1,547 |
$186K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,625 |
1,533 |
$137K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,767 |
2,401 |
$120K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,097 |
1,069 |
$91K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
859 |
839 |
$51K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
541 |
531 |
$29K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
309 |
300 |
$27K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,336 |
1,180 |
$18K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
213 |
205 |
$12K |
| 86780 |
|
242 |
228 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
114 |
114 |
$7K |
| 81025 |
|
818 |
766 |
$4K |
| 86803 |
|
54 |
53 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
140 |
134 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
48 |
48 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
17 |
15 |
$2K |
| 87340 |
|
54 |
53 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
201 |
195 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
75 |
69 |
$2K |
| 99442 |
|
49 |
41 |
$1K |
| 85027 |
|
30 |
25 |
$864.43 |
| 86701 |
|
127 |
124 |
$853.32 |
| 81001 |
|
67 |
64 |
$739.83 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25 |
25 |
$523.51 |
| 87210 |
|
12 |
12 |
$38.32 |
| 87220 |
|
12 |
12 |
$38.32 |