| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
959 |
805 |
$458K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
206 |
193 |
$141K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
60 |
52 |
$37K |
| 0011A |
|
14 |
14 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
19 |
14 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$8K |
| 92015 |
Determination of refractive state |
62 |
57 |
$682.00 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$0.00 |
| D1120 |
Prophylaxis - child |
21 |
21 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
34 |
34 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
22 |
22 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
22 |
22 |
$0.00 |
| 91301 |
|
17 |
17 |
$0.00 |