| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
1,607 |
1,207 |
$138K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
55 |
46 |
$7K |
| 80061 |
Lipid panel |
995 |
991 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
942 |
938 |
$6K |
| 99348 |
|
195 |
195 |
$5K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
229 |
186 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,184 |
1,052 |
$5K |
| 80053 |
Comprehensive metabolic panel |
1,167 |
1,132 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,329 |
1,257 |
$4K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
564 |
564 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
912 |
903 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
67 |
64 |
$3K |
| 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 |
27 |
25 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
212 |
203 |
$2K |
| 59425 |
|
22 |
14 |
$2K |
| 96156 |
|
70 |
70 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
200 |
180 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
210 |
202 |
$1K |
| 81001 |
|
422 |
416 |
$707.86 |
| 82274 |
|
55 |
50 |
$685.97 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$591.36 |
| 82043 |
|
182 |
181 |
$394.50 |
| 84153 |
|
43 |
43 |
$389.07 |
| Q3014 |
Telehealth originating site facility fee |
16 |
15 |
$367.04 |
| 82570 |
|
182 |
181 |
$356.10 |
| 84481 |
|
35 |
35 |
$352.30 |
| 82607 |
|
64 |
63 |
$291.98 |
| A0425 |
Ground mileage, per statute mile |
154 |
92 |
$284.33 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
37 |
$274.40 |
| 86592 |
|
188 |
186 |
$238.50 |
| 84439 |
|
97 |
97 |
$221.03 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
50 |
49 |
$211.85 |
| 81003 |
|
347 |
336 |
$172.47 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
31 |
27 |
$160.50 |
| 96127 |
|
49 |
44 |
$158.73 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
78 |
75 |
$143.92 |
| 36415 |
Collection of venous blood by venipuncture |
419 |
404 |
$141.99 |
| 92551 |
|
96 |
94 |
$131.59 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
49 |
49 |
$131.55 |
| 99000 |
|
133 |
132 |
$127.05 |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
616 |
491 |
$81.25 |
| 80076 |
|
26 |
26 |
$70.18 |
| 92015 |
Determination of refractive state |
12 |
12 |
$55.51 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
121 |
120 |
$54.83 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
41 |
$49.06 |
| 99173 |
|
161 |
160 |
$47.35 |
| 85018 |
|
107 |
107 |
$43.69 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
70 |
70 |
$43.52 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
116 |
116 |
$40.52 |
| 81002 |
|
58 |
58 |
$25.80 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
14 |
14 |
$23.50 |
| 90686 |
|
70 |
70 |
$23.49 |
| 90658 |
|
55 |
55 |
$22.70 |
| 99199 |
Unlisted special service, procedure or report |
194 |
165 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90734 |
|
43 |
43 |
$0.00 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
15 |
13 |
$0.00 |
| 90649 |
|
30 |
30 |
$0.00 |
| 81000 |
|
64 |
63 |
$0.00 |
| 85027 |
|
31 |
31 |
$0.00 |