| Code | Description | Claims | Beneficiaries | Total Paid |
| 59426 |
|
2,008 |
812 |
$193K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,859 |
2,009 |
$133K |
| 59425 |
|
632 |
399 |
$55K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,233 |
1,100 |
$36K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
614 |
563 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
247 |
230 |
$17K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
564 |
518 |
$17K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
563 |
518 |
$17K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
185 |
176 |
$13K |
| 85027 |
|
1,562 |
1,426 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
126 |
95 |
$8K |
| 81025 |
|
1,083 |
917 |
$6K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
111 |
74 |
$5K |
| 87808 |
|
403 |
370 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
25 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
28 |
$2K |
| 87210 |
|
417 |
381 |
$2K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
28 |
25 |
$2K |
| 90674 |
|
111 |
71 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
146 |
103 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
102 |
100 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
122 |
118 |
$1K |
| 90756 |
|
36 |
33 |
$817.65 |
| 59025 |
Fetal non-stress test |
67 |
26 |
$462.60 |
| 81000 |
|
14 |
12 |
$47.06 |