| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
166 |
149 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
62 |
$2K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
14 |
12 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
186 |
184 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
469 |
467 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
671 |
640 |
$812.45 |
| 84443 |
Thyroid stimulating hormone (TSH) |
504 |
500 |
$217.70 |
| 80053 |
Comprehensive metabolic panel |
642 |
620 |
$116.11 |
| 83540 |
|
13 |
13 |
$78.55 |
| 85652 |
|
52 |
49 |
$75.33 |
| 87340 |
|
26 |
26 |
$59.62 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
12 |
12 |
$23.50 |
| 84439 |
|
139 |
139 |
$22.67 |
| 86592 |
|
152 |
152 |
$19.20 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
109 |
109 |
$9.76 |
| 81003 |
|
305 |
299 |
$1.74 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
32 |
28 |
$0.00 |
| A0425 |
Ground mileage, per statute mile |
124 |
65 |
$0.00 |
| 80061 |
Lipid panel |
525 |
524 |
$0.00 |
| 1159F |
|
27 |
27 |
$0.00 |
| 80076 |
|
12 |
12 |
$0.00 |
| 84550 |
|
46 |
46 |
$0.00 |
| 82570 |
|
12 |
12 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$0.00 |
| 87186 |
|
12 |
12 |
$0.00 |
| 84436 |
|
169 |
167 |
$0.00 |
| 2001F |
|
57 |
33 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
254 |
254 |
$0.00 |
| 86803 |
|
27 |
27 |
$0.00 |
| 84153 |
|
35 |
35 |
$0.00 |
| 3008F |
|
113 |
89 |
$0.00 |
| 84479 |
|
135 |
133 |
$0.00 |
| 85027 |
|
57 |
56 |
$0.00 |
| 83550 |
|
12 |
12 |
$0.00 |
| 84480 |
|
40 |
40 |
$0.00 |
| 81001 |
|
31 |
31 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
107 |
107 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
436 |
411 |
$0.00 |
| 82043 |
|
26 |
26 |
$0.00 |
| 0001F |
|
56 |
31 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
187 |
185 |
$0.00 |
| 82607 |
|
50 |
50 |
$0.00 |
| 82746 |
|
35 |
35 |
$0.00 |
| 86140 |
|
13 |
12 |
$0.00 |