| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
424 |
401 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,096 |
998 |
$5K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
23 |
22 |
$2K |
| 80061 |
Lipid panel |
302 |
302 |
$2K |
| 96151 |
|
247 |
247 |
$2K |
| 92552 |
|
385 |
385 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
226 |
226 |
$1K |
| 80053 |
Comprehensive metabolic panel |
170 |
161 |
$953.60 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
201 |
192 |
$857.63 |
| 96156 |
|
25 |
25 |
$850.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
77 |
70 |
$390.96 |
| 90686 |
|
103 |
102 |
$360.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
34 |
32 |
$334.73 |
| 83525 |
|
50 |
50 |
$292.69 |
| 84460 |
|
97 |
97 |
$281.27 |
| 84450 |
|
96 |
96 |
$266.98 |
| 85018 |
|
494 |
494 |
$229.60 |
| 82947 |
|
109 |
109 |
$220.81 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$154.30 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$153.80 |
| 81003 |
|
91 |
91 |
$115.18 |
| 99000 |
|
146 |
142 |
$68.21 |
| 99173 |
|
413 |
413 |
$20.43 |
| 3008F |
|
38 |
38 |
$6.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
63 |
63 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
134 |
134 |
$0.00 |
| 90734 |
|
24 |
24 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
43 |
43 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
77 |
77 |
$0.00 |
| 90651 |
|
72 |
72 |
$0.00 |
| 86580 |
|
33 |
33 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
15 |
$0.00 |