| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81513 |
|
281 |
276 |
$27K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
902 |
898 |
$23K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
902 |
898 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
823 |
761 |
$21K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
154 |
131 |
$9K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
118 |
118 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
281 |
276 |
$7K |
| 84703 |
|
706 |
687 |
$4K |
| 87800 |
|
109 |
108 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
121 |
120 |
$2K |
| 76830 |
Ultrasound, transvaginal |
25 |
25 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
110 |
108 |
$2K |
| 88142 |
|
117 |
117 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
141 |
137 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
36 |
$1K |
| 86780 |
|
148 |
145 |
$1K |
| S4993 |
Contraceptive pills for birth control |
15 |
15 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
26 |
26 |
$766.48 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$169.32 |
| A4267 |
Contraceptive supply, condom, male, each |
12 |
12 |
$71.82 |
| 81003 |
|
39 |
38 |
$58.59 |
| 1000F |
|
224 |
214 |
$0.00 |
| 3008F |
|
215 |
202 |
$0.00 |
| 3044F |
|
70 |
65 |
$0.00 |
| 3074F |
|
133 |
125 |
$0.00 |
| 1036F |
|
85 |
84 |
$0.00 |
| 87481 |
|
265 |
261 |
$0.00 |
| 3078F |
|
144 |
136 |
$0.00 |
| 1160F |
|
213 |
199 |
$0.00 |