| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
207 |
206 |
$58K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
547 |
546 |
$25K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
533 |
532 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
205 |
201 |
$17K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
196 |
196 |
$7K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
203 |
203 |
$6K |
| 86780 |
|
322 |
322 |
$6K |
| 59025 |
Fetal non-stress test |
93 |
36 |
$4K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
28 |
28 |
$3K |
| 85027 |
|
294 |
290 |
$3K |
| 86803 |
|
121 |
121 |
$2K |
| 87340 |
|
137 |
137 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
56 |
56 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
86 |
86 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
26 |
26 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
93 |
90 |
$1K |
| 81025 |
|
103 |
100 |
$990.20 |
| 90686 |
|
33 |
33 |
$972.95 |
| 86850 |
|
37 |
37 |
$428.24 |
| 86901 |
|
37 |
37 |
$149.71 |
| 86900 |
|
37 |
37 |
$149.71 |