| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
373 |
372 |
$17K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
372 |
371 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
110 |
110 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$6K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
82 |
82 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
69 |
$2K |
| 90686 |
|
54 |
54 |
$2K |
| 86780 |
|
81 |
81 |
$1K |
| 85027 |
|
99 |
99 |
$854.10 |
| 86803 |
|
13 |
13 |
$255.45 |
| 87340 |
|
13 |
13 |
$184.86 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14 |
14 |
$150.50 |