| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
992 |
902 |
$22K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
918 |
835 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
561 |
538 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
303 |
299 |
$16K |
| 86703 |
|
781 |
768 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
323 |
308 |
$7K |
| 86592 |
|
849 |
826 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
37 |
37 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
143 |
141 |
$2K |
| 87210 |
|
605 |
588 |
$2K |
| 90686 |
|
44 |
42 |
$860.86 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
37 |
36 |
$828.63 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
41 |
39 |
$632.10 |
| 86803 |
|
52 |
51 |
$449.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
41 |
38 |
$348.00 |
| 81025 |
|
55 |
54 |
$290.70 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$256.10 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90714 |
|
12 |
12 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |