| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
309 |
308 |
$37K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,134 |
1,129 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,133 |
1,128 |
$32K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
360 |
357 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
164 |
162 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
130 |
127 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
52 |
52 |
$3K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
81 |
81 |
$3K |
| 81025 |
|
145 |
142 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$851.70 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12 |
12 |
$360.36 |
| 86780 |
|
12 |
12 |
$200.40 |
| 81002 |
|
15 |
14 |
$57.48 |
| S4993 |
Contraceptive pills for birth control |
13 |
13 |
$0.00 |