| Code | Description | Claims | Beneficiaries | Total Paid |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
406 |
402 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
403 |
399 |
$8K |
| T1015 |
Clinic visit/encounter, all-inclusive |
86 |
69 |
$5K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
132 |
131 |
$4K |
| 87481 |
|
39 |
39 |
$3K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
64 |
64 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
100 |
99 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
39 |
39 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
756 |
687 |
$1K |
| 80053 |
Comprehensive metabolic panel |
103 |
96 |
$925.02 |
| 87511 |
|
39 |
39 |
$716.19 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
154 |
144 |
$657.74 |
| Q3014 |
Telehealth originating site facility fee |
49 |
49 |
$656.22 |
| 86803 |
|
25 |
25 |
$477.57 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
27 |
27 |
$470.28 |
| 90686 |
|
15 |
15 |
$469.56 |
| 85027 |
|
71 |
69 |
$417.72 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
25 |
$261.60 |
| 86780 |
|
20 |
20 |
$261.54 |
| 87340 |
|
24 |
24 |
$213.25 |
| 81025 |
|
64 |
61 |
$193.84 |
| 80061 |
Lipid panel |
13 |
13 |
$189.14 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
31 |
31 |
$183.61 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
27 |
26 |
$153.32 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$144.20 |
| 71046 |
Radiologic examination, chest; 2 views |
13 |
13 |
$127.69 |
| 86850 |
|
26 |
26 |
$110.73 |
| 86900 |
|
26 |
26 |
$104.87 |
| 86901 |
|
26 |
26 |
$58.99 |
| 86592 |
|
12 |
12 |
$50.40 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.00 |