| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76830 |
Ultrasound, transvaginal |
524 |
524 |
$38K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,323 |
1,307 |
$30K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,323 |
1,307 |
$30K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
262 |
262 |
$18K |
| 81513 |
|
141 |
139 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
291 |
281 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
382 |
365 |
$10K |
| 88142 |
|
595 |
593 |
$10K |
| 84703 |
|
1,348 |
1,296 |
$8K |
| S4993 |
Contraceptive pills for birth control |
87 |
87 |
$8K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
211 |
211 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
128 |
127 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
42 |
42 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
141 |
139 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
40 |
25 |
$2K |
| 86780 |
|
201 |
197 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
166 |
161 |
$2K |
| 87800 |
|
25 |
25 |
$917.00 |
| 81003 |
|
251 |
246 |
$468.72 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
16 |
$237.51 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$155.21 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$89.76 |
| 85027 |
|
14 |
14 |
$76.02 |
| 87481 |
|
128 |
127 |
$0.00 |