| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,002 |
995 |
$14K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,001 |
995 |
$14K |
| 99401 |
|
2,043 |
1,916 |
$11K |
| 86703 |
|
880 |
870 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
658 |
630 |
$6K |
| 86780 |
|
338 |
331 |
$888.52 |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
1,971 |
1,892 |
$455.65 |
| 86803 |
|
36 |
36 |
$247.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$177.80 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
13 |
$140.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
42 |
$136.00 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
583 |
549 |
$61.30 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$54.25 |
| 3074F |
|
196 |
184 |
$10.00 |
| 36415 |
Collection of venous blood by venipuncture |
569 |
551 |
$5.40 |
| 99422 |
|
13 |
12 |
$4.66 |
| G0445 |
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes |
217 |
206 |
$4.06 |
| 99000 |
|
1,114 |
1,084 |
$3.64 |
| 1126F |
|
197 |
186 |
$0.00 |
| 3079F |
|
14 |
14 |
$0.00 |
| 3511F |
|
280 |
275 |
$0.00 |
| 1159F |
|
252 |
236 |
$0.00 |
| 1160F |
|
252 |
236 |
$0.00 |
| 3078F |
|
67 |
63 |
$0.00 |