| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95886 |
|
1,374 |
1,347 |
$68K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,395 |
1,310 |
$64K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
531 |
509 |
$58K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
63 |
38 |
$29K |
| 95117 |
|
1,372 |
840 |
$29K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
511 |
500 |
$28K |
| 87481 |
|
356 |
337 |
$24K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
609 |
577 |
$23K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
771 |
747 |
$19K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
658 |
635 |
$15K |
| X0621 |
|
72 |
52 |
$14K |
| 95911 |
|
155 |
152 |
$11K |
| 95910 |
|
110 |
110 |
$10K |
| 17110 |
|
217 |
209 |
$9K |
| Q3014 |
Telehealth originating site facility fee |
523 |
495 |
$8K |
| 92567 |
|
593 |
575 |
$7K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
255 |
247 |
$7K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
188 |
183 |
$7K |
| 96900 |
|
405 |
94 |
$6K |
| 11102 |
|
164 |
145 |
$5K |
| 95885 |
|
131 |
129 |
$5K |
| 92557 |
|
145 |
142 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
195 |
192 |
$4K |
| 86003 |
|
25 |
24 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
212 |
206 |
$3K |
| 64615 |
|
31 |
27 |
$3K |
| 81025 |
|
622 |
603 |
$3K |
| 87150 |
|
54 |
54 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
247 |
244 |
$2K |
| 94010 |
|
86 |
83 |
$2K |
| 95909 |
|
16 |
16 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
254 |
246 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
156 |
127 |
$1K |
| 76830 |
Ultrasound, transvaginal |
26 |
26 |
$1K |
| 84439 |
|
151 |
150 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
17 |
13 |
$1K |
| 80053 |
Comprehensive metabolic panel |
83 |
80 |
$901.72 |
| 95908 |
|
12 |
12 |
$806.34 |
| 31231 |
|
12 |
12 |
$764.74 |
| 31575 |
|
12 |
12 |
$670.87 |
| 91200 |
|
34 |
34 |
$574.92 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
56 |
56 |
$554.59 |
| X0592 |
|
12 |
12 |
$467.60 |
| 82784 |
|
27 |
26 |
$297.80 |
| 82105 |
|
14 |
14 |
$265.54 |
| 69210 |
|
15 |
12 |
$255.83 |
| G0008 |
Administration of influenza virus vaccine |
25 |
25 |
$231.71 |
| 87511 |
|
12 |
12 |
$231.23 |
| 36415 |
Collection of venous blood by venipuncture |
135 |
135 |
$204.15 |
| 80061 |
Lipid panel |
13 |
12 |
$191.17 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30 |
29 |
$182.07 |
| 17000 |
|
13 |
13 |
$171.35 |
| 85610 |
|
28 |
28 |
$97.57 |
| 86140 |
|
12 |
12 |
$34.08 |
| 90686 |
|
227 |
227 |
$0.00 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
29 |
29 |
$0.00 |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
14 |
14 |
$0.00 |
| 90715 |
|
174 |
173 |
$0.00 |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
72 |
66 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
590 |
589 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
122 |
122 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
30 |
30 |
$0.00 |