| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 3078F |
|
1,033 |
990 |
$0.00 |
| 86703 |
|
15 |
15 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
225 |
213 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
135 |
135 |
$0.00 |
| 80061 |
Lipid panel |
331 |
330 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
355 |
355 |
$0.00 |
| 90734 |
|
51 |
51 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$0.00 |
| G9920 |
Screening performed and negative |
349 |
349 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
160 |
160 |
$0.00 |
| 85014 |
|
12 |
12 |
$0.00 |
| 84460 |
|
32 |
32 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
162 |
162 |
$0.00 |
| 96160 |
|
152 |
152 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
17 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 3074F |
|
1,049 |
999 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
208 |
208 |
$0.00 |
| 90686 |
|
150 |
150 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
546 |
529 |
$0.00 |
| 82728 |
|
77 |
77 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
661 |
651 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
148 |
148 |
$0.00 |
| 3044F |
|
153 |
153 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
13 |
13 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
836 |
828 |
$0.00 |
| 99441 |
|
66 |
65 |
$0.00 |
| 90651 |
|
105 |
105 |
$0.00 |
| 86780 |
|
14 |
14 |
$0.00 |
| 90656 |
|
117 |
117 |
$0.00 |
| 1111F |
|
177 |
173 |
$0.00 |
| 96161 |
|
167 |
167 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$0.00 |
| 4450F |
|
12 |
12 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |