| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
123 |
98 |
$30.00 |
| 80053 |
Comprehensive metabolic panel |
93 |
83 |
$21.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
57 |
$0.00 |
| 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 |
13 |
13 |
$0.00 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
14 |
14 |
$0.00 |
| 81003 |
|
25 |
24 |
$0.00 |