| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
336 |
316 |
$340K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
430 |
416 |
$66K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,453 |
1,306 |
$61K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
48 |
47 |
$59K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
417 |
406 |
$47K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
427 |
412 |
$45K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
440 |
426 |
$36K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
549 |
537 |
$35K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
710 |
677 |
$31K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
297 |
252 |
$29K |
| 86780 |
|
435 |
422 |
$25K |
| 86481 |
|
142 |
139 |
$21K |
| 86850 |
|
240 |
234 |
$20K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
344 |
336 |
$18K |
| 86803 |
|
138 |
136 |
$17K |
| 86787 |
|
155 |
152 |
$17K |
| 86762 |
|
155 |
154 |
$17K |
| 59426 |
|
25 |
24 |
$17K |
| 86900 |
|
240 |
234 |
$16K |
| 86901 |
|
240 |
234 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
142 |
139 |
$14K |
| 83020 |
|
75 |
75 |
$13K |
| 76801 |
|
247 |
238 |
$10K |
| T1015 |
Clinic visit/encounter, all-inclusive |
67 |
59 |
$10K |
| 59430 |
|
87 |
84 |
$9K |
| 87340 |
|
105 |
103 |
$9K |
| 81001 |
|
149 |
147 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
419 |
403 |
$8K |
| 83021 |
|
75 |
75 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
83 |
79 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
25 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
76 |
76 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
138 |
127 |
$4K |
| 82950 |
|
136 |
134 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
515 |
498 |
$4K |
| 59025 |
Fetal non-stress test |
113 |
99 |
$3K |
| 82105 |
|
53 |
53 |
$3K |
| 81025 |
|
532 |
519 |
$2K |
| 84702 |
|
26 |
24 |
$2K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
39 |
28 |
$2K |
| 87150 |
|
19 |
19 |
$2K |
| 82677 |
|
12 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36 |
34 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
26 |
25 |
$1K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12 |
12 |
$697.66 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
14 |
$610.10 |
| 86336 |
|
12 |
12 |
$433.32 |
| 81002 |
|
79 |
69 |
$144.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$89.10 |
| 87210 |
|
18 |
17 |
$70.80 |