| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
2,090 |
1,458 |
$88K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
431 |
408 |
$19K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
430 |
407 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
273 |
232 |
$11K |
| 59514 |
|
18 |
12 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
97 |
87 |
$7K |
| 76830 |
Ultrasound, transvaginal |
56 |
53 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
413 |
348 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
26 |
25 |
$2K |
| 0500F |
|
36 |
36 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
28 |
27 |
$2K |
| 87088 |
|
94 |
86 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$858.99 |
| 59430 |
|
17 |
17 |
$852.55 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32 |
29 |
$776.28 |
| 80081 |
|
13 |
13 |
$734.16 |
| 87210 |
|
155 |
147 |
$723.80 |
| 90686 |
|
39 |
37 |
$655.38 |
| 82950 |
|
139 |
122 |
$580.75 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
37 |
37 |
$363.54 |
| 88142 |
|
75 |
75 |
$251.25 |
| 59025 |
Fetal non-stress test |
21 |
16 |
$243.30 |
| 86592 |
|
49 |
41 |
$180.00 |
| 84702 |
|
18 |
13 |
$150.62 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
13 |
$137.34 |
| 81025 |
|
20 |
16 |
$49.02 |
| 36415 |
Collection of venous blood by venipuncture |
286 |
251 |
$10.10 |