| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81513 |
|
412 |
406 |
$48K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,250 |
1,223 |
$36K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,250 |
1,223 |
$36K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
566 |
478 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
985 |
856 |
$24K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
239 |
239 |
$18K |
| S4993 |
Contraceptive pills for birth control |
261 |
257 |
$17K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
412 |
406 |
$12K |
| 87800 |
|
254 |
250 |
$9K |
| 88142 |
|
463 |
458 |
$8K |
| 84703 |
|
1,069 |
1,033 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
150 |
148 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
264 |
260 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
107 |
107 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
55 |
55 |
$2K |
| 86780 |
|
112 |
111 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
86 |
58 |
$1K |
| 81003 |
|
180 |
173 |
$339.93 |
| 90686 |
|
13 |
13 |
$239.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
41 |
$219.52 |
| 3008F |
|
398 |
377 |
$0.00 |
| 3044F |
|
76 |
66 |
$0.00 |
| 1000F |
|
289 |
275 |
$0.00 |
| 3079F |
|
12 |
12 |
$0.00 |
| 3074F |
|
275 |
264 |
$0.00 |
| 1036F |
|
165 |
154 |
$0.00 |
| 3075F |
|
38 |
38 |
$0.00 |
| 87481 |
|
316 |
313 |
$0.00 |
| 1160F |
|
241 |
232 |
$0.00 |
| 3078F |
|
306 |
292 |
$0.00 |