| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80061 |
Lipid panel |
191 |
191 |
$44.50 |
| 84443 |
Thyroid stimulating hormone (TSH) |
187 |
187 |
$26.88 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
38 |
38 |
$20.70 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$20.70 |
| 80053 |
Comprehensive metabolic panel |
222 |
222 |
$17.72 |
| 86592 |
|
58 |
57 |
$17.44 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
153 |
153 |
$15.52 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
274 |
272 |
$13.50 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
25 |
$0.00 |
| 84439 |
|
24 |
24 |
$0.00 |
| G9920 |
Screening performed and negative |
20 |
20 |
$0.00 |
| 81003 |
|
13 |
13 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
326 |
208 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
13 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12 |
12 |
$0.00 |