| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| U0004 |
Cov-19 test non-cdc hgh thru |
5,459 |
3,462 |
$476K |
| G2023 |
Specimen collect covid-19 |
2,220 |
1,718 |
$93K |
| 99204 |
|
1,064 |
681 |
$78K |
| 99203 |
|
1,601 |
1,038 |
$71K |
| 99214 |
|
803 |
498 |
$58K |
| 99213 |
|
1,025 |
651 |
$47K |
| 99385 |
|
480 |
320 |
$43K |
| U0005 |
Infec agen detec ampli probe |
1,562 |
1,211 |
$39K |
| 99384 |
|
252 |
161 |
$23K |
| 99386 |
|
232 |
156 |
$22K |
| U0002 |
Covid-19 lab test non-cdc |
338 |
263 |
$17K |
| U0003 |
Cov-19 amp prb hgh thruput |
199 |
131 |
$15K |
| 87426 |
|
415 |
303 |
$15K |
| 99383 |
|
173 |
99 |
$14K |
| 99223 |
Prolong inpt eval add15 m |
196 |
189 |
$14K |
| A4927 |
Non-sterile gloves |
681 |
522 |
$4K |
| 99222 |
|
61 |
54 |
$4K |
| 99382 |
|
32 |
17 |
$3K |
| 87804 |
|
50 |
31 |
$2K |
| 99072 |
|
264 |
167 |
$775.00 |
| 92611 |
|
13 |
13 |
$714.35 |
| A9270 |
Non-covered item or service |
296 |
236 |
$0.00 |
| S5175 |
Laundry serv,ext,prof,/order |
294 |
235 |
$0.00 |
| E0700 |
Safety equipment |
297 |
237 |
$0.00 |
| A4245 |
Alcohol wipes per box |
297 |
237 |
$0.00 |
| A4928 |
Surgical mask |
297 |
237 |
$0.00 |
| A4618 |
Breathing circuits |
17 |
17 |
$0.00 |