| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0064A |
|
491 |
487 |
$259K |
| 0002A |
|
316 |
312 |
$156K |
| 0001A |
|
296 |
292 |
$143K |
| 0003A |
|
278 |
276 |
$134K |
| 0072A |
|
224 |
218 |
$122K |
| 0071A |
|
203 |
201 |
$104K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
182 |
171 |
$90K |
| 0012A |
|
188 |
186 |
$87K |
| 0011A |
|
182 |
180 |
$82K |
| 0124A |
|
121 |
121 |
$74K |
| 0053A |
|
120 |
120 |
$73K |
| 0054A |
|
97 |
97 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,386 |
1,228 |
$18K |
| 99000 |
|
37 |
37 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
469 |
419 |
$9K |
| 42700 |
|
16 |
15 |
$7K |
| 92567 |
|
15 |
15 |
$3K |
| 92310 |
|
12 |
12 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
227 |
107 |
$2K |
| V2020 |
Frames, purchases |
121 |
111 |
$1K |
| 92587 |
|
14 |
14 |
$1K |
| 36416 |
|
422 |
385 |
$932.61 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
26 |
$335.16 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
35 |
20 |
$130.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
14 |
$92.22 |
| 82962 |
|
503 |
470 |
$59.27 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
142 |
142 |
$56.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 90694 |
|
16 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
24 |
24 |
$0.00 |