| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
317 |
317 |
$13K |
| 90658 |
|
343 |
340 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
147 |
147 |
$5K |
| 92551 |
|
375 |
375 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
701 |
669 |
$1K |
| 92081 |
|
485 |
485 |
$1K |
| 80053 |
Comprehensive metabolic panel |
447 |
439 |
$630.24 |
| 80061 |
Lipid panel |
443 |
443 |
$601.16 |
| 85018 |
|
242 |
242 |
$511.75 |
| 84443 |
Thyroid stimulating hormone (TSH) |
110 |
110 |
$414.25 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
102 |
102 |
$407.52 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
225 |
224 |
$261.58 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
430 |
429 |
$245.79 |
| 90734 |
|
28 |
28 |
$201.60 |
| 90620 |
|
27 |
27 |
$194.40 |
| 90649 |
|
26 |
26 |
$187.20 |
| 92015 |
Determination of refractive state |
13 |
13 |
$104.13 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$61.72 |
| 81001 |
|
123 |
119 |
$53.27 |
| 84436 |
|
160 |
160 |
$51.77 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
639 |
606 |
$28.96 |
| 84100 |
|
119 |
119 |
$15.42 |
| 84550 |
|
121 |
121 |
$10.35 |
| 83615 |
|
116 |
115 |
$8.66 |
| 82043 |
|
12 |
12 |
$5.03 |
| 90791 |
Psychiatric diagnostic evaluation |
313 |
313 |
$0.00 |
| G9920 |
Screening performed and negative |
659 |
659 |
$0.00 |
| 82977 |
|
113 |
113 |
$0.00 |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
135 |
117 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
49 |
48 |
$0.00 |
| 96160 |
|
352 |
352 |
$0.00 |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
32 |
32 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
12 |
12 |
$0.00 |
| 82465 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
292 |
292 |
$0.00 |
| 3008F |
|
63 |
60 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
190 |
188 |
$0.00 |
| 3074F |
|
27 |
26 |
$0.00 |
| 96161 |
|
202 |
202 |
$0.00 |
| 0001A |
|
14 |
14 |
$0.00 |