| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4657 |
Syringe, with or without needle, each |
68,166 |
2,063 |
$765K |
| 36415 |
Collection of venous blood by venipuncture |
46,290 |
3,733 |
$582K |
| D1110 |
Prophylaxis - adult |
5,615 |
1,763 |
$226K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
5,306 |
1,040 |
$156K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,510 |
4,221 |
$137K |
| D0140 |
Limited oral evaluation - problem focused |
1,305 |
584 |
$44K |
| D7140 |
Extraction, erupted tooth or exposed root |
286 |
152 |
$21K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
92 |
80 |
$10K |
| D1120 |
Prophylaxis - child |
189 |
42 |
$8K |
| 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 |
635 |
606 |
$7K |
| 85018 |
|
669 |
109 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
318 |
274 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
35 |
27 |
$3K |
| 97597 |
|
23 |
12 |
$2K |
| 80053 |
Comprehensive metabolic panel |
281 |
79 |
$2K |
| 0001A |
|
47 |
47 |
$943.05 |
| 0002A |
|
37 |
37 |
$891.06 |
| 83970 |
|
359 |
34 |
$661.80 |
| 0003A |
|
16 |
16 |
$640.00 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
835 |
787 |
$227.20 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30 |
24 |
$83.69 |