| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
926 |
907 |
$33K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
926 |
907 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
377 |
336 |
$23K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
304 |
303 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
81 |
$8K |
| 87480 |
|
330 |
324 |
$8K |
| 87660 |
|
330 |
324 |
$7K |
| 86780 |
|
324 |
323 |
$5K |
| 87510 |
|
306 |
300 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
93 |
93 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
37 |
37 |
$2K |
| 86803 |
|
43 |
43 |
$898.70 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
12 |
12 |
$788.76 |
| 81025 |
|
59 |
59 |
$698.56 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
21 |
20 |
$317.73 |
| 81003 |
|
20 |
19 |
$68.20 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
47 |
47 |
$0.00 |