| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
97 |
91 |
$0.00 |
| 99334 |
|
1,046 |
889 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
308 |
161 |
$0.00 |
| 11721 |
|
117 |
117 |
$0.00 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
323 |
217 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
156 |
150 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
47 |
46 |
$0.00 |
| A0425 |
Ground mileage, per statute mile |
414 |
278 |
$0.00 |
| 83540 |
|
193 |
189 |
$0.00 |
| 11720 |
|
91 |
91 |
$0.00 |
| 1160F |
|
129 |
126 |
$0.00 |
| 80074 |
|
195 |
193 |
$0.00 |
| 82570 |
|
138 |
135 |
$0.00 |
| 1159F |
|
130 |
126 |
$0.00 |
| T4541 |
Incontinence product, disposable underpad, large, each |
140 |
140 |
$0.00 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
155 |
122 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
28 |
$0.00 |
| 84439 |
|
88 |
87 |
$0.00 |
| 99336 |
|
339 |
328 |
$0.00 |
| 84481 |
|
12 |
12 |
$0.00 |
| 80061 |
Lipid panel |
951 |
946 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
20 |
18 |
$0.00 |
| A4927 |
Gloves, non-sterile, per 100 |
25 |
25 |
$0.00 |
| 90653 |
|
69 |
69 |
$0.00 |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
138 |
99 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
186 |
184 |
$0.00 |
| 85610 |
|
50 |
43 |
$0.00 |
| 84100 |
|
31 |
27 |
$0.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
32 |
28 |
$0.00 |
| 99223 |
Prolong inpt eval add15 m |
69 |
59 |
$0.00 |
| 86480 |
|
31 |
31 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
124 |
100 |
$0.00 |
| 81003 |
|
13 |
13 |
$0.00 |
| 80164 |
|
49 |
48 |
$0.00 |
| 99233 |
Prolong inpt eval add15 m |
78 |
26 |
$0.00 |
| S3645 |
Hiv-1 antibody testing of oral mucosal transudate |
12 |
12 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
27 |
27 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,089 |
917 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
325 |
297 |
$0.00 |
| 99000 |
|
71 |
71 |
$0.00 |
| 1126F |
|
30 |
30 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,745 |
1,375 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
59 |
36 |
$0.00 |
| 99335 |
|
788 |
761 |
$0.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
12 |
12 |
$0.00 |
| 85018 |
|
24 |
24 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
458 |
454 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
111 |
110 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
1,523 |
1,304 |
$0.00 |
| 82043 |
|
162 |
161 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
135 |
91 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
753 |
747 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
177 |
177 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,931 |
1,707 |
$0.00 |
| 87088 |
|
53 |
53 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
319 |
134 |
$0.00 |
| 81001 |
|
488 |
482 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
869 |
861 |
$0.00 |
| 82728 |
|
164 |
162 |
$0.00 |
| 82746 |
|
148 |
147 |
$0.00 |
| 83550 |
|
189 |
186 |
$0.00 |
| 3074F |
|
27 |
26 |
$0.00 |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
125 |
104 |
$0.00 |
| 2001F |
|
60 |
59 |
$0.00 |
| 2000F |
|
84 |
83 |
$0.00 |
| 3008F |
|
52 |
48 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
185 |
183 |
$0.00 |
| 84153 |
|
172 |
172 |
$0.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
220 |
169 |
$0.00 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
227 |
185 |
$0.00 |
| 84480 |
|
39 |
39 |
$0.00 |
| 82607 |
|
159 |
158 |
$0.00 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
226 |
56 |
$0.00 |
| 86592 |
|
213 |
213 |
$0.00 |
| 85027 |
|
112 |
109 |
$0.00 |
| 84436 |
|
59 |
59 |
$0.00 |
| 82962 |
|
339 |
306 |
$0.00 |
| 1000F |
|
25 |
25 |
$0.00 |
| 86706 |
|
12 |
12 |
$0.00 |
| 83690 |
|
17 |
12 |
$0.00 |
| G0471 |
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) |
17 |
15 |
$0.00 |
| 83735 |
|
24 |
17 |
$0.00 |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
39 |
27 |
$0.00 |
| 1125F |
|
13 |
12 |
$0.00 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14 |
12 |
$0.00 |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
13 |
13 |
$0.00 |